Alarm interventions for nocturnal enuresis in children

Glazener, Cathryn; Evans, Jonathan; Peto, RE

doi:10.1002/14651858.cd002911

Cited by 45 publications

(41 citation statements)

References 90 publications

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“…18 Alarm treatment efficacy has been reported in widely varying bands from 30% to 87% with almost universal relapse. [45][46][47][48] Only the study by van Zwet et al 46 demonstrated a 0% relapse in one of the age groups studied. Desmopressin response varies between 38% to 59% but with extremely high and rapid relapse rates within a few weeks of cessation of treatment.…”

Section: Discussionmentioning

confidence: 99%

Chiropractic Treatment for Primary Nocturnal Enuresis: A Case Series of 33 Consecutive Patients

Poecke¹,

Cunliffe²

2009

Journal of Manipulative and Physiological Therapeutics

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Section: Discussionmentioning

confidence: 99%

Chiropractic Treatment for Primary Nocturnal Enuresis: A Case Series of 33 Consecutive Patients

Poecke¹,

Cunliffe²

2009

Journal of Manipulative and Physiological Therapeutics

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“…Previous studies have confirmed the clinical efficacy of enuretic alarms or desmopressin in the treatment of nocturnal enuresis. The Cochrane collaboration concluded that patients treated by the enuretic alarms are 3.7 times more likely than those receiving no treatment to achieve sustained remission [8]. Patients receiving oral desmopressin treatment are 4.6 times more likely to achieve short-term remission than controls, although relapses are likely [9].…”

Section: Discussionmentioning

confidence: 99%

“…Such psycho-emotional effects were found to improve after treatment of PNE [5,6,7]. Studies in Western countries have shown that enuresis alarms were four times more effective than no treatment in achieving 14 consecutive dry nights, and that this beneficial effect persisted in 31%-61% of patients after 3 months [8]. Desmopressin was similarly effective during treatment but was not better than placebo in the long term [9].…”

Section: Introductionmentioning

confidence: 99%

Comparing alarms, desmopressin, and combined treatment in Chinese enuretic children

Wong

2004

Pediatr Nephrol

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The objective of this multicenter randomized controlled trial was to compare the efficacy of enuresis alarms, oral desmopressin, and combined treatment in Chinese children with monosymptomatic primary nocturnal enuresis. We assigned 105 children aged 7-15 years to receive alarms (group 1, 35 patients), oral desmopressin 400 mug (group 2, 38 patients), or combined therapy (group 3, 32 patients) for 12 weeks; patients were then followed for 12 weeks after treatment. The wetting frequency decreased during treatment by 46%, 52%, and 73% in groups 1, 2, and 3, respectively. In groups 2 and 3, but not in group 1, there was rebound post treatment, but significant improvements persisted at 12 weeks. The complete and partial response rates were 22.9% and 20%, respectively in group 1, 42% and 10.5% in group 2, and 62.5% and 15.6% in group 3. By Kaplan-Meier analysis, group 1 had a significantly poorer response than groups 2 and 3. Of the responders, 20%, 60%, and 40% in groups 1, 2, and 3, respectively, relapsed after stopping treatment. In conclusion, enuresis alarms and/or oral desmopressin were less efficacious in Chinese than in Western societies. Desmopressin produced an immediate effect but relapses were common. Alarms took several weeks to produce a benefit, which was persistent on follow-up.

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“…Für die Enuresis-Alarmsysteme werden Erfolgsraten von 60-70% in der Literatur berichtet [3]. Allerdings manifestieren sich häu-fig Rückfälle nach der Behandlung mit Alarmsystemen (15-30%) [3], und das wissenschaftliche Niveau der meisten publizierten Studien ist bescheiden; außerdem ist nur eine Minorität dieser Studien randomisiert (weniger als 5%) [7]. Eine neue Metaanalyse hat aufgezeigt, dass bei den aktuelleren Studien zu Enuresis-Alarmsystemen weitaus weniger eindrucksvolle Ergebnisse berichtet werden [10].…”

Section: Diskussionunclassified

Therapiealgorithmus bei Enuresis nocturna

et al. 2004

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Monotherapeutic strategies often have only partial success in primary nocturnal enuresis (PNE). This analysis evaluated whether adjuvant treatment strategies improve outcomes. PNE children were submitted to a distinct therapeutic strategy including urotherapy (behavioral modifications), a first-line and, if necessary, a second-line treatment period. Outcome was the relief of bedwetting, the follow-up was 3-79 months. Urotherapy was applied. Nonresponders were assigned to desmopressin as first-line treatment. For complete responders a structured withdrawal program was applied. Partial responders were assigned to adjuvant second-line treatment according to their individual symptomatology, masked at basic investigations, incorporating either anticholinergics (propiverine hydrochloride), biofeedback, alpha-blocker (alfuzosin), alarm or psychotherapy, in addition to desmopressin. Nonresponders were referred to specialized management. The study included 259 children suffering from PNE (92 girls, 167 boys, aged 5-18 years): 42 children were relieved from bedwetting after urotherapy and 136 children had a complete response to desmopressin. Three nonresponders were assigned to specialized management, 61 partial responders had adjuvant treatments, and 17 partial responders had no further treatment. The suggested treatment algorithm resulted in 227 complete responders, 29 partial responders, and 3 nonresponders. The need for preliminary urotherapy is evident. The proposed desmopressin monotherapeutic strategy, incorporating a structured withdrawal program, is more effective than the standard desmopressin treatment module. Applying adjuvant treatment modules improves the complete response rate up to 88%. In partial responders overall efficacy rates are improved further. Nonresponders (1.2%) will be referred to specialized management, but many partial responders will gain improvement sufficient to refrain from invasive procedures.

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Alarm interventions for nocturnal enuresis in children

Cited by 45 publications

References 90 publications

Chiropractic Treatment for Primary Nocturnal Enuresis: A Case Series of 33 Consecutive Patients

Chiropractic Treatment for Primary Nocturnal Enuresis: A Case Series of 33 Consecutive Patients

Comparing alarms, desmopressin, and combined treatment in Chinese enuretic children

Therapiealgorithmus bei Enuresis nocturna

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