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Complex behavioural and educational interventions for nocturnal enuresis in children
C M A Glazener1, J H C Evans, R E Peto
1Health Services Research Unit (Foresterhill Lea), University of Aberdeen, Foresterhill, Aberdeen, Scotland, UK, AB25 2ZD.
The Cochrane Database of Systematic Reviews
|February 20, 2004
Summary
Complex behavioral interventions like dry bed training (DBT) combined with alarms are effective for childhood nocturnal enuresis (bedwetting). Alarms alone are effective, but combining them with DBT may further reduce relapse rates.
Area of Science:
- Pediatric urology
- Behavioral science
- Evidence-based medicine
Background:
- Nocturnal enuresis affects 15-20% of five-year-olds, causing significant distress.
- It impacts children and young adults, necessitating effective treatment strategies.
Purpose of the Study:
- To evaluate complex behavioral and educational interventions for childhood nocturnal enuresis.
- To compare these interventions against other treatment methods.
Main Methods:
- Systematic review of randomized and quasi-randomized trials up to December 2002.
- Included complex behavioral/educational interventions, excluding daytime wetting-only trials.
- Compared interventions against no treatment, simple methods, alarms, and medications.
Main Results:
- Complex interventions (e.g., dry bed training (DBT), full spectrum home training (FSHT)) with alarms outperformed no-treatment controls.
- A complex intervention alone was less effective than an alarm alone or combined with an alarm.
- Combining DBT with an alarm showed potential to reduce relapse rates compared to alarm monotherapy.
Conclusions:
- DBT and FSHT with alarms are effective, but evidence for their use without alarms is insufficient.
- Alarms are effective, and combining them with DBT may enhance treatment outcomes.
- Direct therapist contact may improve intervention effectiveness, warranting further research.