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Interventions for Enuresis in Children and Adolescents: An Overview of Systematic Reviews
Eduarda Correia Moretti1,2, Ivson Bezerra da Silva3, Alessandra Boaviagem4
1Department of Anatomy, Federal University of Pernambuco, Child and Adolescent Health, Federal University of Pernambuco - Recife (PE), Brazil.
Background:
Enuresis is an involuntary and intermittent loss of urine during sleep, and its treatment can be done by pharmacological and non-pharmacological strategies.
Objective:
To conduct an overview to carry out a survey of the systematic reviews about treatment options for children/adolescents with enuresis.
Methods:
Databases used were Cochrane Library, PROSPERO, MEDLINE/PubMed, EMBASE, LILACS/BVS, PEDro, SciELO and Google Scholar. Any type of intervention for the treatment of enuresis in children/adolescents was selected by two independent researchers. Data extraction was done by two independent researchers. The risk of bias was assessed using Risk of Bias in Systematic Reviews (ROBIS) and A MeaSurement Tool to Assess Systematic Reviews (AMSTAR-2).
Results:
Seven systematic reviews were included. According to ROBIS, three reviews had a low risk of bias, while the others had a high risk of bias. Based on AMSTAR-2, four systematic reviews were of moderate quality, two were low quality, and one was critically low quality.
Conclusion:
There is moderate confidence that the use of desmopressin plus an anticholinergic agent increases the chance of complete response compared to desmopressin alone. Neurostimulation may increase the risk of responses ≥50% and ≥90% compared to the control group. Likewise, it appears that electrical stimulation is superior to placebo about the chance of response ≥50%. In addition, there is clinical relevance in reducing enuresis episodes per week when neurostimulation is used compared to control groups.
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