Enuresis Management in Children: Retrospective Clinical Audit of 2861 Cases Treated with Practitioner-Assisted
Esther Apos1, Sharynn Schuster1, John Reece2
1Division of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia.
Insights
Practitioner-assisted bell-and-pad alarm therapy is highly effective for treating childhood enuresis, achieving a 76% success rate. This method helps establish dryness and provides a basis for improved clinical guidelines.
Area of Science:
- Pediatric Urology
- Sleep Medicine
- Behavioral Therapy
Background:
- Childhood enuresis (bedwetting) affects a significant number of children, impacting their quality of life and presenting management challenges.
- Bell-and-pad alarm therapy is a recognized treatment modality for enuresis, but its efficacy across diverse patient populations requires further clarification.
Purpose of the Study:
- To evaluate the treatment efficacy of practitioner-assisted bell-and-pad alarm therapy in children aged 5–16 years with enuresis.
- To determine the time to achieve sustained dryness and assess relapse rates associated with this therapy.
Main Methods:
- Retrospective chart review of 2861 children across 7 Australian clinical practices.
- Primary outcome: time to 14 consecutive dry nights. Secondary outcome: relapse rates post-treatment.
- Statistical analysis included correlation and chi-squared tests using IBM SPSS Statistics (version 22).
Main Results:
- An overall success rate of 76% was observed, with a mean treatment duration of 62.1 days to achieve dryness.
- The relapse rate was 23%. Concurrent bowel dysfunction (74% success) and lower urinary tract symptoms (73% success) were associated with lower efficacy.
- Children with secondary enuresis showed significantly higher success rates (82%) compared to primary enuresis (74%).
Conclusions:
- Practitioner-assisted bell-and-pad alarm therapy demonstrates high effectiveness in treating childhood enuresis.
- Findings support the development of clinical guidelines to standardize and improve care pathways for enuresis alarm treatment.
Objective:
To establish the treatment efficacy of practitioner-assisted bell-and-pad alarm therapy in children with enuresis between the ages of 5 and 16 years by retrospective medical chart review of 2861 children in multiple clinical settings.
Study Design:
This review was conducted across 7 Australian clinical practices. The primary outcome measure was the time taken for children with either primary, secondary, monosymptomatic, or nonmonosymptomatic enuresis to be dry for 14 consecutive nights. The secondary outcome measure was to determine relapse rates, defined as 1 symptom recurrence per month post interruption of treatment. Data were analyzed by correlation and χ2 test via IBM SPSS Statistics (version 22).
Results:
The overall success rate of the bell and pad treatment was 76%, irrespective of age. The mean treatment time to achieve dryness was 62.1 ± 30.8 days, and the relapse rate was 23%. Concurrent bowel dysfunction was associated with a slightly lower success rate (74%). Concurrent lower urinary tract symptoms were associated with a lower success rate (73%) and greater relapse (1.75 times more likely to relapse). Children with secondary enuresis had significantly greater success than those with primary enuresis (82% vs 74%).
Conclusion:
The type of alarm therapy reported in this study is highly effective. This study will provide the basis for clinical guidelines and practice tools for clinicians, which will help to reduce variation in care pathways for alarm treatment for enuresis.
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