Simple behavioral methods seem to be inferior to enuresis alarm therapy or some drug therapy, but they are superior to no active treatment for nocturnal enuresis in children, according to research published online in The Cochrane Library.
Patrina H.Y. Caldwell, PhD, of the University of Sydney in Australia, and colleagues conducted an intervention review of randomized or quasi-randomized trials of simple behavioral treatments for nocturnal enuresis in children up to age 16.
The researchers found that 16 trials involving 1,643 children met the inclusion criteria; 865 children received a simple behavioral intervention. In single, small trials, rewards for dry nights, lifting and waking, and bladder training each were associated with significantly fewer wet nights, higher full response rates, and lower relapse rates compared with controls. However, simple behavioral methods seemed less effective than enuresis alarm therapy or drug therapy with imipramine or amitriptyline. No single simple behavioral therapy appeared to be more effective than any other.
“Simple behavioral interventions are commonly used by families for treating nocturnal enuresis,” the authors wrote. “However, other proven effective therapies such as enuresis alarm therapy and tricyclic antidepressants were found to be more effective than simple behavioral interventions.”