ENURESIS ALARM TREATMENT AS A SECOND LINE TO PHARMACOTHERAPY IN CHILDREN WITH MONOSYMPTOMATIC NOCTURNAL ENURESIS

Abstract

We evaluate the effectiveness of enuresis alarm as second line therapy for partial or nonresponders to pharmacotherapy. We recommended enuresis alarm treatment for 67 partial or nonresponders to pharmacotherapy for monosymptomatic nocturnal enuresis. Of these patients 28 were evaluable by inclusion and exclusion criteria. We analyzed the effectiveness of enuresis alarm therapy using the response criteria defined by the reduction rate of wet nights, defined as complete response (greater than 90%), partial response (50% to 90%) and no response (less than 50%). We defined initial and lasting cure when patients showed persistent full response for 4 weeks and 6 months after cessation of all treatments, respectively. After pharmacotherapy partial responders showed a mean response of 81.2%. On the other hand, nonresponders exhibited a mean response of 26.4% with more than 20 wet nights in 4 weeks. After using second line enuresis alarm treatment 90.5% (19 of 21) of partial responders became full responders and 71.4% (15 of 21), 61.9% (13 of 21) of partial responders showed initial and lasting cure, respectively. In addition, 71.4% (5 of 7) of nonresponders became full responders and 57.1% (4 of 7) exhibited initial and lasting cure. Enuresis alarm as second line therapy for monosymptomatic nocturnal enuresis is effective for lasting cure as well as high initial full response rate in partial and nonresponders to pharmacotherapy. Therefore, enuresis alarm is a reasonable second line therapeutic option for partial or nonresponders to pharmacotherapy.