Complementary and miscellaneous interventions for nocturnal enuresis in children

Area of Science:

• Pediatrics
• Complementary and Alternative Medicine
• Urology

Background:

• Nocturnal enuresis (bedwetting) affects 15-20% of five-year-olds and up to 2% of young adults.
• It is a socially disruptive and stressful condition for affected children and their families.

Purpose of the Study:

• To evaluate the effectiveness of complementary interventions for childhood nocturnal enuresis.
• To compare these interventions with conventional treatments such as surgery, diet, and medication.

Main Methods:

• Systematic review of randomized and quasi-randomized trials.
• Searched multiple databases including PubMed, EMBASE, and Chinese medical literature databases.
• Included trials on complementary and miscellaneous interventions, excluding those solely for daytime wetting.

Main Results:

• 24 trials involving 2334 children were analyzed; trial quality was generally poor.
• Hypnosis showed better outcomes than imipramine; psychotherapy outperformed alarm and reward systems.
• Medicinal herbs demonstrated better results than desmopressin; acupuncture and chiropractic adjustments were also found to be effective compared to sham treatments.
• Evidence for diet and faradization was unreliable; no trials on homeopathy or surgery were found.

Conclusions:

• Limited evidence suggests potential benefits of hypnosis, psychotherapy, acupuncture, chiropractic, and medicinal herbs for nocturnal enuresis.
• Findings are based on small, single trials with methodological limitations.
• Robust, high-quality randomized trials are essential to confirm efficacy, cost-effectiveness, and report adverse effects.