Abstract
Objective: Nocturnal enuresis is a common problem among children. This multifactorial disease is a source of stress of the families. Therefore, it is important how to approach the disorder, plan the treatment in order to provide a satisfactory cure rate. The aim of this study was to evaluate the long term results of alarm therapy after an initial response. Materials Methods: The study consisted of 36 of 50 patients with nocturnal enuresis, that were responded alarm therapy after three months treatment. At the end of the second year, detailed interviews with the parents of the children were recorded. Results: It was found that only 6 (16.7%) patients achieved complete dryness with the alarm device and no different treatment modalities were needed after the initial success. The remaining 30 (83.3%) patients had recurrence in the subsequent period and 25 (%83.3) of them tried retreatment. Conclusions: In long term follow up recurrence rates are high and families may seek different treatment approaches. Recurrence probabilities should be emphasized to the families at the beginning of the alarm treatment for monosymptomatic nocturnal enuresis.
Highlights
Nocturnal enuresis is a widespread problem among children
Recurrence probabilities should be emphasized to the families at the beginning of the alarm treatment for monosymptomatic nocturnal enuresis
The literature reports a variety of potential treatments. they do take longer than pharmacological interventions to work and require effort from both the children and the families, alarms are recommended as a first-line treatment to be used after advice on fluids, toileting, and rewards, as the long-term success rate is satisfactory in the literature
Summary
Nocturnal enuresis is a widespread problem among children. The prevalence estimates of enuresis are highly variable but approximately 15% of children wet the bed at night at age five, and there is a spontaneous resolution rate of about 15% per year as Robson (2009) mentioned. Enuresis is categorized as monosymptomatic(MNE) and nonmonosymptomatic (NMNE) and primary and secondary forms by Nevéus (2006). It is a source of stress for the children, as well as for their families, who may incur significant financial costs. The literature reports a variety of potential treatments (e.g. enuresis alarms, imipramine, desmopressin, oxybutinin, and complex regimens such as dry-bed training and combined treatments etc.). they do take longer than pharmacological interventions to work and require effort from both the children and the families, alarms are recommended as a first-line treatment to be used after advice on fluids, toileting, and rewards, as the long-term success rate is satisfactory in the literature. The present study was conducted to evaluate the long term success rates of alarm therapy on monosymptomatic nocturnal enuresis. Information from this study should assist both health professionals and families in planning treatment strategies of MNE since responsiveness and relapses are important considerations when selecting an optimal outcome
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