The Treatment of Nocturnal Enuresis in Children: An Overview

Abstract

Background: The aim of this review was to compare the efficacy of acupuncture therapy in the treatment of nocturnal enuresis with placebo acupuncture or oral pharmacological treatment based on randomized controlled trials. Materials and Methods: Two independent researchers screened the meta-analysis articles on the effect of treatment nocturnal enuresis in children. The databases included Scopus, EMBASE, Cochrane, Web of Science, and Medline, with no time and language restrictions from the beginning up to March 10, 2020. Results: The first meta-analysis showed that therapy with the combination of desmopressin and anticholinergics (combination therapy) was significantly better than desmopressin monotherapy. The second meta-analysis showed that structured withdrawal from desmopressin treatment compared with the abrupt withdrawal results in a significantly better relapse-free rate (pooled RR: 1.38; 95% confidence interval [CI]: 1.17–1.63; P=0.0001). The third meta-analysis reported a 31% rate of successful treatment for rapid palatal expansion, which is promising compared to the spontaneous cure rate. In the fourth meta-analysis, the pooled data showed a significant difference between acupuncture and meclofenoxate therapy (OR=2.81). No significant difference was observed between acupuncture, desmopressin (OR = 1.57), imipramine hydrochloride (OR = 1.71), and oxybutynin (OR = 3.57). In the fifth meta-analysis, a statistically significant difference was observed between the frequency of enuresis per week (P < 0.001), the number of patients with clinical response (P Conclusion: Therapy with the combination of desmopressin and anticholinergics (combination therapy) produced significantly better results than desmopressin monotherapy. The findings showed the positive effects of acupuncture therapy and rapid palatal expansion on nocturnal enuresis in children.