NOCTURNAL ENURESIS (1997)

A systematic review of the effectiveness of interventions for managing childhood nocturnal enuresis

Background

The aim of this project was to conduct a systematic review of the international research to assess and compare the effectiveness of different treatments for nocturnal enuresis. Bed wetting in children affects 20% of five year-olds and 5% of ten year-olds and is a cause of much psychological suffering for children and their families.

Findings

Over sixty of the most reliable trials were identified and analysed. These show that a variety of behavioural and pharmacological treatments are effective. The use of enuresis alarms is over 13 times more likely to help children achieve at least 14 consecutive dry nights compared to no treatment. This behavioural treatment can take several months to work fully. The drugs imipramine and desmopressin can reduce the number of wet nights per week quite quickly. However, the effect is not as sustained as enuresis alarms and both have potentially serious side effects. Desmopressin is much more expensive but no more effective than imipramine. Other commonly used forms of management such as star charts and rewards, fluid deprivation and lifting have not been reliably evaluated.

Conducted by: Deborah Lister-Sharp1, Susan O' Meara1, Matthew Bradley1, Trevor A Sheldon1

1. NHS Centre for Reviews and Dissemination

Publications

A systematic review of the effectiveness of interventions for managing childhood nocturnal enuresis. CRD Report 11. York: University of York. 1997

Funding

Commissioned by the Enuresis Resource and Information Centre