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Evidence summaries

Behavioural and Physical Interventions for Nocturnal Enuresis in Children

Simple behavioural interventions, such as rewarding and lifting, may be effective for some children with nocturnal enuresis compared to no therapy. However, they appear to be inferior to enuresis alarm therapy and imipramine and amitriptyline. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 16 studies with a total of 1 643 subjects. In two trials, alarm therapy was superior to bladder training. In single small trials, reward systems (e.g. star charts), lifting and waking and bladder training were each associated with significantly fewer wet nights, higher cure rates and lower relapse rates compared to controls. Simple behavioural interventions appeared to be less effective when compared with other known effective interventions (such as enuresis alarm therapy and drug therapies with imipramine and amitriptyline). However, the effect was not sustained at follow-up after completion of treatment for the drug therapies. Based on one small trial, cognitive therapy also appeared to be more effective than rewards. When one simple behavioural therapy was compared with another, there did not appear to be one therapy that was more effective than another.

    References

    • Caldwell PH, Nankivell G, Sureshkumar P. Simple behavioural interventions for nocturnal enuresis in children. Cochrane Database Syst Rev 2013;(7):CD003637. [PubMed]

Primary/Secondary Keywords