Simple behavioural interventions for nocturnal enuresis in children

Area of Science:

• Pediatrics
• Urology
• Behavioral Science

Background:

• Nocturnal enuresis (bedwetting) affects 15-20% of five-year-olds and up to 2% of adults, causing significant social and emotional distress.
• Simple behavioral interventions, requiring minimal child effort, are often a first-line approach for managing bedwetting.

Purpose of the Study:

• To evaluate the effectiveness of simple behavioral interventions for treating nocturnal enuresis in children.
• To compare simple behavioral interventions against no treatment, other behavioral methods, and drug therapies.

Main Methods:

• Systematic review of randomized and quasi-randomized controlled trials involving children up to 16 years old with nocturnal enuresis.
• Searched major databases including Cochrane Incontinence Group Specialised Trials Register, CENTRAL, and MEDLINE up to December 2011.

Main Results:

• Sixteen trials involving 1643 children were included; meta-analysis was precluded due to single-trial comparisons.
• Simple behavioral interventions like rewards, lifting/waking, and bladder training showed improvements over no treatment.
• Enuresis alarm therapy was superior to bladder training; drug therapies (imipramine, amitriptyline) showed short-term benefits but effects waned post-treatment.

Conclusions:

• Simple behavioral interventions may be more effective than no treatment but less effective than enuresis alarm therapy or certain drug therapies.
• These interventions can be considered as a first-line treatment option before escalating to more demanding therapies, despite limited evidence for their superiority.