Treating nocturnal enuresis in children

review of evidence

C. M. A. Glazener, J. H. C. Evans, R. E. Peto

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

BACKGROUND: Childhood nocturnal enuresis (bedwetting) affects many families. Although it has a high rate of spontaneous remission, bedwetting may bring social and emotional stigma, stress, and inconvenience to both the child with enuresis and his or her family.

DESIGN: Summary of systematic reviews of treatment for nocturnal enuresis in children, published in the Cochrane Library, using evidence only from randomized and quasi-randomized trials to compare interventions. Interventions included behavioral, alarm, and pharmacologic treatments.

SETTING AND METHODS: Six Cochrane Reviews contributed evidence to this review: simple behavioral interventions, alarms, complex behavioral or educational interventions, desmopressin, tricyclics and related drugs, and other drugs.

SUBJECTS: The participants were children (usually up to the age of 16).

RESULTS: Much of the available evidence was of poor quality, and there were few direct comparisons between different types of intervention. Simple behavioral Interventions, such as reward systems, are widely used as standard first-line treatment, but they require a high level of parental involvement. There is currently little evidence to show that these interventions work, but they may be worth trying because they have only a few adverse effects.

The use of an alarm intervention reduced nighttime bed wetting in a majority of children both during and after treatment. Overlearning or dry-bed training may reduce the relapse rate. Before embarking on alarm treatment, families need to be made aware of both the time and the high level of parental involvement necessary to attain success.

Drug therapy, such as desmopressin and tricyclics, reduced the number of wet nights per week compared with placebo but only while the drug was used. Patients and their families need to be warned about possible side effects of some of the drugs.

CONCLUSIONS: Alarms are the most effective treatment for nocturnal enuresis in children, but desmopressin may be considered for temporary relief.
Original languageEnglish
Pages (from-to)223-234
Number of pages12
JournalJournal of Wound , Ostomy , & Continence Nursing
Volume31
Issue number4
Publication statusPublished - Jul 2004

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Nocturnal Enuresis
Deamino Arginine Vasopressin
Overlearning
Therapeutics
Social Stigma
Pharmaceutical Preparations
Spontaneous Remission
Enuresis
Drug-Related Side Effects and Adverse Reactions
Reward
Psychological Stress
Libraries
Placebos
Recurrence
Drug Therapy

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Treating nocturnal enuresis in children : review of evidence. / Glazener, C. M. A.; Evans, J. H. C.; Peto, R. E.

In: Journal of Wound , Ostomy , & Continence Nursing, Vol. 31, No. 4, 07.2004, p. 223-234.

Research output: Contribution to journalArticle

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