A Prospective and Randomized Study comparing observation, imipramine, desmopressin acetate (DDAVP) and bedwetting alarm for the treatment of nocturnal monossymptomatic enuresis

Trigo Rocha F1, Reis J1, Saiovici S1, Mello L1, Cabral B1, Gejer D1

Research Type

Clinical

Abstract Category

Paediatrics

Abstract 727
Non Discussion Abstracts
Scientific Non Discussion Abstract Session 36
Incontinence Pediatrics Nocturnal Enuresis Conservative Treatment
1. Hospital Sirio Libanes/ Hospital Menino Jesus
Links

Abstract

Hypothesis / aims of study
This study was approved by Ethics Committee in our Hospital. Enuresis has a high prevalence among children with high impact in their quality of life and in the families. We have compared prospectively different approaches for this condition analyzing efficacy, safety and relapse.
Study design, materials and methods
We have studied 93 consecutive children (55 males and 38 females) in our service with a diagnosis of nocturnal monossymptomatic enuresis. All patients were submitted to behavior therapy during 3three months: timely voiding, fluids restriction, improvement in bowel function. After this period all patients remained with behavior therapy. The patients who remained with enuresis were randomized for observation (behavior only), bedwetting alarm, imipramine (maximum doses= 25 mg/Day) and desmopressin (maximum doses= 0,4 mg/Day).
Results
Table 1 show demography and improvement in enuresis following the four treatment modalities. Alarm was superior to observation, DDAVP and imipramine for both (p= 0,015; 0,001 and 0,012 respectively). After 6 months 65 % of children treated with alarms had no enuresis anymore. No significant side effects were observed with any form of treatment
Interpretation of results
Bedwetting alarms are a safe and effective treatment for monossymptomatic enuresis. When compared with other treatment options they result in higher levels of cure and lower levels of relapse.
Concluding message
Bedwetting alarms should b the first choice in the treatment of monossymptomatic enuresis. Other options may remain a second line of treatment for children who do not accept or not respond to alarms
Figure 1
Disclosures
Funding None Clinical Trial Yes Registration Number Plataforma Brasil RCT Yes Subjects Human Ethics Committee Comite de Ética em Pesquisa Hospital Menino Jesus Helsinki Yes Informed Consent Yes
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