Meta analysis of the alarm treatment and desmopressin in the treatment of primary nocturnal enuresis in children

Abstract

Objective To explore the therapy efficacy for children with primary nocturnal enuresis by meta-analysis on the efficiency of alarm treatment versus desmopressin. Methods PubMed, Central, Elesvier, CNKI and some other databases were browsed to obtain all randomized controlled trails(RCT) and to compare the therapy between alarm treatment and desmopressin.Data extraction and quality evaluation were done by methods recommended by Cochrane center.The results of short-term and long-term efficacy and compliance were analyzed by Review Manager 5.0. Results Fifty-four RCT were retrieved and 11 RCT were included in the study.There was no statistical difference between alarm treatment and desmopressin when analyzing by no wetting episode, wetting no more than 1 night per month, wetting nights' decrease over 90% or wetting nights decrease over 50%.By 3-month follow-up after treatment stopped, alarm treatment significantly reduced the wetting nights to over 50% or less than 1 night per month than desmopressin.By 6-month follow-ups after treatment stopped, there was no difference between alarm treatment and desmopressin when analyzed by wetting no more than 1 night.The relapse rate of desmopressin was higher than that of alarm treatment(P=0.007). However, the withdrawal and abandonment rate of alarm treatment was higher than that of desmopressin(P<0.000 01). Severe adverse effects were not found in both of the treatment groups. Conclusions There is no statistical difference between alarm and desmopressin therapy in short-term treatment.The efficiency of alarm device is better than that of desmopressin in long-term treatment.The follow-up of alarm treatment lost more than that of desmopressin.Desmopressin is better than the alarm treatment in compliance but has higher recurrence rate. Key words: Primary nocturnal enuresis; Alarm treatment; Desmopressin; Meta analysis; Child