What is the best treatment for nocturnal enuresis in children?

Area of Science:

• Pediatric urology
• Sleep medicine
• Behavioral therapy

Background:

• Primary nocturnal enuresis affects many children.
• Effective treatment options are crucial for improving quality of life.

Purpose of the Study:

• To evaluate the efficacy of enuresis alarms and pharmacotherapy for primary nocturnal enuresis.
• To compare the effectiveness of different treatment modalities.

Main Methods:

• Systematic review of homogeneous randomized control trials (RCTs).
• Analysis of treatment outcomes for enuresis alarms, desmopressin (DDAVP), and tricyclic drugs.
• Evaluation of dry bed training combined with alarms.

Main Results:

• Enuresis alarms reduced wet nights by nearly 4 per week, with sustained dryness in almost half of patients post-treatment.
• Desmopressin (DDAVP) and tricyclic drugs showed a 1-2 weekly reduction in wet nights during treatment, without sustained effects.
• Dry bed training with alarms provided additional benefits over alarms alone.

Conclusions:

• Enuresis alarms are a highly effective treatment for primary nocturnal enuresis with lasting results.
• Pharmacological treatments offer short-term benefits but lack sustained efficacy.
• Combined dry bed training and alarm therapy enhance treatment outcomes.