The Efficacy of Enuresis Alarm Treatment in Pharmacotherapy-Resistant Nocturnal Enuresis

Abstract

To assess the efficacy of enuresis alarm (EA) treatment in pharmacotherapy-resistant nocturnal enuresis (PRNE). A retrospective study was performed in children who received EA treatment as a form of combination treatment for PRNE from June 1999 to December 2007. The children included 54 monosymptomatic nocturnal enuresis (MNE) children who had partial response or nonresponse to desmopressin (group 1), 25 nonmonosymptomatic nocturnal enuresis (NMNE) children who had partial response or nonresponse to extended release oxybutynin plus desmopressin (group 2), and 21 MNE or NMNE children who relapsed after responding fully to first-line pharmacotherapy (group 3). EA treatment outcomes were determined as outlined by the International Children's Continence Society Standardisation Committee. Overall, 50% and 53.7%, 40%, and 52.4% of children in groups 1, 2, and 3, respectively, responded fully to EA treatment (no significant differences). In groups 1 and 2, 54.4% (31/57) of the partial responders and 36.4% (8/22) of the nonresponders showed full response (FR) after EA treatment was initiated. Of the children with small bladder capacities, 56.7% showed FR. Of the full responders in each group, 60.7%, 88.9%, and 54.5% of groups 1, 2, and 3, respectively, did not have relapse 6 months after cessation of treatment. Overall, half of the total population achieved FR, and continued success was observed in more than half of full responders irrespective of the groups. Thus, adding EA treatment to pharmacotherapy is an effective second-line therapeutic strategy for children with PRNE.