Is Second-Line Enuretic Alarm Therapy after Unsuccessful Pharmacotherapy Superior to First-Line Therapy in the Treatment of Monosymptomatic Nocturnal Enuresis?

Tuygun, Can; Eroğlu, Muzaffer; Bakirtas, Hasan; Gücük, Adnan; Zengın, Kürşad; İmamoğlu, Abdurrahim

doi:10.1159/000099349

Cited by 12 publications

(15 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Unfortunately, that study did not report any information on bladder capacity and nocturnal polyuria of the included children. Furthermore, it has been shown that subsequent second-line treatment with an alarm in patients with complete rebound after desmopressin is not effective [16]. On the other hand, an enuresis alarm was proven to be effective as a secondline treatment in partial and non-responders to pharmacotherapy, which is in accordance with the findings of the present study [17].…”

Section: Discussionsupporting

confidence: 91%

Evaluation of different modes of combined therapy in children with monosymptomatic nocturnal enuresis

et al. 2010

View full text Add to dashboard Cite

Study Type – Therapy (RCT) Level of Evidence 1b OBJECTIVE To evaluate the efficacy of different modes of combined therapy in children with monosymptomatic nocturnal enuresis (MNE). PATIENTS AND METHODS A randomized prospective study was performed to compare the order of two types of combined therapy in children with MNE. Group A was treated with primary desmopressin treatment that was combined with alarm treatment after 3 months, while group B was treated with primary alarm treatment that was combined with desmopressin after 3 months. RESULTS Within a period of 18 months, 43 previously untreated children fulfilled the inclusion criteria. Thirteen children achieved dryness after initial monotherapy or discontinued the study. Group A consisted of 16 children and group B of 14 children. After the standardized treatment course of 6 months, 11/16 children in group A and 11/14 children in group B became dry (<3 wet nights/month). Altogether, 22/30 (73%) children were dry after combined treatment, consisting of 12/18 boys and 10/12 girls. Of the children with a normal maximum voided volume, 79% (19/24) achieved dryness, whereas only three of six children with small maximum voided volumes became dry. In all, 13/19 (68%) children with nocturnal polyuria and nine of 11 without nocturnal polyuria became dry. Only one child relapsed (group A). CONCLUSIONS Combined therapy proved effective in children with MNE after 6 months, with no statistically significant differences between the two different orders of treatment.

show abstract

Section: Discussionsupporting

confidence: 91%

Evaluation of different modes of combined therapy in children with monosymptomatic nocturnal enuresis

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Behavioral interventions like bedwetting alarms are rarely used here in practice due to the easy use of medications and the fast response in many cases though alarm therapy has been proven to be successful in some studies. [20] Enuresis is a common problem among school children in Mumbai and needs attention. Very often parents do not report enuresis due to the embarrassment it may cause for the child and many parents assume that bladder control shall be attained over time.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and factors affecting enuresis amongst primary school children

et al. 2007

View full text Add to dashboard Cite

Aims and Objectives:The aim of the study was to establish the prevalence of enuresis in school children and to determine contributing factors along with treatment methods used in these children.Materials and Methods:The parents of 1473 children aged between 6-10 years completed a self-administered semi-structured questionnaire. Socio-demographic profiles, enuresis data, medical and psychiatric disorders and family stressors were collected. The data was analyzed and the results presented.Results:The response rate was 89.22%. The overall prevalence of enuresis was 7.61%. Enuresis was more common in boys. A positive family history of enuresis was seen in 28.57% children; 14.29% of the children had daytime wetting as well. Only 24.11% of the parents had taken their child to a doctor for the problem. Family stressors, significant birth history and lower socioeconomic status was present to a larger extent in the enuretic group. Scholastic backwardness was also an important factor in this group.Conclusions:This study reports on the prevalence of enuresis in school-going children and stresses on the need for parental education and awareness about this problem.

show abstract

“…Six studies did not report the type of alarm. Four studies used an intranasal spray 7 , 17 – 19 , six used oral tablets 16 , 20 – 24 , four used oral melt 25 – 28 , and one used a nasal spray or oral tablets 29 . Dosage titration to 0.4 mg for oral tablets 20 – 24 and 240 μg for oral melt 25 , 28 was performed in seven studies under differed circumstances and time intervals from the initial treatment.…”

Section: Resultsmentioning

confidence: 99%

Systematic Review and Meta-analysis of Alarm versus Desmopressin Therapy for Pediatric Monosymptomatic Enuresis

Peng

Yang

Austin

et al. 2018

Sci Rep

View full text Add to dashboard Cite

This study is to compare the efficacy of enuresis alarm and desmopressin therapy in managing pediatric monosymptomatic enuresis. We performed systematic literature searches on different databases from inception until April 2017 without language restriction. All randomized control trials comparing an enuresis alarm and desmopressin in managing children with monosymptomatic enuresis were included. A total of 15 studies with 1502 participants (aged 5 to 16 years) were included for pooled analysis. Overall, an enuresis alarm outperformed desmopressin in achieving at least a partial response (>50% reduction in wet nights) in per-protocol analysis (OR: 1.53, 95% CI 1.05 to 2.23) but not in intention-to-treat analysis (OR: 0.97, 95% CI 0.73 to 1.30) as the alarm was hampered by a high dropout rate (OR: 2.20, 95% CI 3.41 to 4.29). However, alarm therapy yielded a better sustained response (OR: 2.89, 95% CI 1.38 to 6.04) and lower relapse rate (OR: 0.25, 95% CI 0.12 to 0.50). In the intention to treat analysis, the results revealed that alarm and desmopressin therapy are comparable in efficacy with regards to achieving >50% reduction in baseline wet nights in enuretic children. However, enuresis alarms offer a superior treatment response and a lower relapse rate in well-motivated children.

show abstract

Is Second-Line Enuretic Alarm Therapy after Unsuccessful Pharmacotherapy Superior to First-Line Therapy in the Treatment of Monosymptomatic Nocturnal Enuresis?

Cited by 12 publications

References 32 publications

Evaluation of different modes of combined therapy in children with monosymptomatic nocturnal enuresis

Evaluation of different modes of combined therapy in children with monosymptomatic nocturnal enuresis

Prevalence and factors affecting enuresis amongst primary school children

Systematic Review and Meta-analysis of Alarm versus Desmopressin Therapy for Pediatric Monosymptomatic Enuresis

Contact Info

Product

Resources

About