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Effectiveness of Alarm Therapy in the Treatment of Nocturnal Enuresis in Children

 

Am Fam Physician. 2021 Jan 1;103(1):online.

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ALARM THERAPY FOR NOCTURNAL ENURESIS IN CHILDREN

BenefitsHarms

1 in 2 children using alarm therapy achieved 14 consecutive dry nights by the end of treatment

Alarm therapy is safer than desmopressin, with only 1 child using alarm therapy experiencing an adverse event for every 7 children taking desmopressin experiencing an adverse event

2 in 5 children using alarm therapy maintained 14 consecutive dry nights at follow-up (2 weeks to 31 months after treatment conclusion)

ALARM THERAPY FOR NOCTURNAL ENURESIS IN CHILDREN

BenefitsHarms

1 in 2 children using alarm therapy achieved 14 consecutive dry nights by the end of treatment

Alarm therapy is safer than desmopressin, with only 1 child using alarm therapy experiencing an adverse event for every 7 children taking desmopressin experiencing an adverse event

2 in 5 children using alarm therapy maintained 14 consecutive dry nights at follow-up (2 weeks to 31 months after treatment conclusion)

Details for This Review

Study Population: Children five to 18 years of age with nocturnal enuresis

Efficacy End Points: Percentage of children achieving 14 consecutive dry nights at treatment conclusion (primary outcome), percentage of children maintaining 14 consecutive dry nights two weeks to 31 months after treatment conclusion (secondary outcome)

Harm End Points: Percentage of children with adverse events, including the alarm failing to wake up the child, ringing without urination, waking others, frightening the child, causing discomfort, or being too difficult to use (secondary outcome)

Narrative: Nocturnal enuresis is common in children, affecting up to 20% of five-year-olds, 7.75% of eight-year-olds, 3% of 11-year-olds, and 0.7% of 17-year-olds.13 There is an annual spontaneous remission rate of 14% to 15% during childhood and adolescence.4 Although it is a pathologically benign condition with a high rate of spontaneous remission, it can affect a child's quality of life and self-esteem and impact social, emotional, and psychological well-being. It is important to identify effective interventions for enuresis. This review assessed the effects of alarm therapy for treating nocturnal enuresis in children, compared with other interventions.1

The systematic review included 74 randomized or quasirandomized controlled trials, involving a total of 5,983 children. The

Author disclosure: No relevant financial affiliations.


Copyright © 2021 MD Aware, LLC (theNNT.com). Used with permission.

This series is coordinated by Christopher W. Bunt, MD, AFP assistant medical editor, and Daniel Runde, MD, from the NNT Group.

A collection of Medicine by the Numbers published in AFP is available at https://www.aafp.org/afp/mbtn.

References

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1. Caldwell PH, Codarini M, Stewart F, et al. Alarm interventions for nocturnal enuresis in children. Cochrane Database Syst Rev. 2020;(5):CD002911....

2. Shreeram S, He J, Kalaydjian A, et al. Prevalence of enuresis and its association with attention-deficit/hyperactivity disorder among U.S. children: results from a nationally representative study. J Am Acad Child Adolesc Psychiatry. 2009;48(1):35–41.

3. Byrd RS, Weitzman M, Lanphear NE, et al. Bed-wetting in US children: epidemiology and related behavior problems. Pediatrics. 1996;98(3 pt 1):414–419.

4. Forsythe WI, Redmond A. Enuresis and spontaneous cure rate. Study of 1129 enuretics. Arch Dis Child. 1974;49(4):259–263.

 

 

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