Treatment of Bedwetting
JAMAPublished 21 April 1975
Mark A. Stewart
Citations29
SJR quartileQ1
SJR score5.35
SNIP10.71
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TL;DR
The three methods of treatment for the rascal are reviewed in this communication: advice and encouragement, prescribing antidepressants, or conditioning with an alarm system, together with the evidence for their effectiveness.
Abstract
A CONTEMPORARY expert might suggest three forms of treatment for the rascal: advice and encouragement, prescribing antidepressants, or conditioning with an alarm system. The three methods are reviewed in this communication, together with the evidence for their effectiveness. The first method is old and tried, but few data are available on its success; the use of antidepressants has been subjected to rigorous and well-controlled study; and while conditioning does not lend itself to controlled research, careful reports exist on its use that can be compared to the results of other approaches. These are the treatments most often used in the United States, Britain, Canada, and Australia, but several others must be mentioned: bladder training, surgery, psychotherapy, and other drug regimens. The functional capacity of an enuretic child's bladder is smaller, on the average, than that of a normal child, and becoming "dry" may be associated with an increased capacity.1-3The
Keywords
MedicineNeuroscienceHealth Professions
ScienceSleep Disorders: Disorders of Arousal?
638 Citations1968Roger Broughton
The classical sleep disorders of nocturnal enuresis, somnambulism, the nightmare, and the sleep terror occur preferentially during arousal from slow-wave sleep and are virtually never associated with the rapid-eye-movement dreaming state.
PubMedThe age of attaining bladder control.
123 Citations1968Wallace C. Oppel, Paul A. Harper +1 more
The Journal of PediatricsEnuresis—an etiologic and therapeutic study
120 Citations1965John S. Werry, John J. Cohrssen
A 4 month controlled treatment trial showed that the bedbuzzer or conditioning treatment, though producing a cure rate of only 30 per cent, is significantly superior to brief psychotherapy and spontaneous remission, though the latter two do not differ in end result.
The Journal of PediatricsA controlled study of imipramine (Tofranil) in the treatment of childhood enuresis
114 Citations1965Alvin F. Poussaint, Keith S. Ditman
In a double-blind, placebo-controlled study with corssver, 47 enuretic children were treated for 8 weeks and it was found that imipramine in doses of 25 or 50 mg.
Archives of Pediatrics and Adolescent MedicineEnuresis in Twins
105 Citations1971Harry Bakwin
Comparison of the incidence of enuresis in monozygotic and same-sex dizygotic twins revealed that bed-wetting after the fourth birthday was present in 146 out of 676 twin children, an incidence of 22%.
The Journal of PediatricsIncrease in functional bladder capacity and improvements in enuresis
102 Citations1968Bárbara Starfield, E. David Mellits
A follow-up study of 83 children with enuresis demonstrates a relationship between increased bladder capacity and improvement inEnuresis and the effect of age on functional bladder capacity.
Archives of Disease in ChildhoodControl of enuresis with imipramine.
87 Citations1968D. Shaffer, Anthony J. Costello +1 more
In this welter of literature, only 12 satisfactorily designed trials are noted, and only 2 of these were conducted on children referred to a paediatric out-patient clinic, the remainder having been carried out on children in institutions, service recruits, or disturbed children being seen at a psychiatric centre.
The Journal of UrologyNocturnal Functional Bladder Capacity in Enuretic Children
76 Citations1971Charles W. Troup, Norman B. Hodgson
American Journal of PsychiatryArousal and Nonarousal Enuretic Events
69 Citations1969Edward Ritvo, Edward M. Ornitz +5 more
The authors formulate a somatopsychic model for the etiology of enuresis, hypothesizing a pathophysiological substrate to explain the phenomenon.
BMJEnuresis and the Electric Alarm—A Study of 200 Cases
64 Citations1970W. I. Forsythe, Amy M. Redmond
Of 200 children with persistent enuresis 66% were cured after treatment with an electric alarm over a 30-week period, and a two-year follow-up period is necessary before a cure can be accepted.
PEDIATRICSSOCIAL, PSYCHOLOGICAL, AND NEUROLOGICAL FACTORS ASSOCIATED WITH NOCTURNAL ENURESIS
61 Citations1968Wallace C. Oppel, Paul A. Harper +1 more
Data on 859 children, who have been followed longitudinally from birth through 12 years, display associations of nocturnal enuresis with neurological, social, and psychological factors and various groups were formed, taking into account age of attaining ness and presence or absence of relapse.
PEDIATRICSENURESIS: AN ANALYSIS OF VARIOUS THERAPEUTIC APPROACHES
51 Citations1973Sumner Marshall, Hermine H. Marshall +1 more
There is a trend showing that the "responsibility-reinforcement" technique produces more successful longterm results than the therapies employing instrumentation-surgery, medications, or conditioning devices.
American journal of diseases of childrenImipramine Pamoate in the Treatment of Childhood Enuresis
48 Citations1971Gilbert I. Martin
Both dosage levels of imipramine produced a statistically significant decrease in the number of wet nights when compared to placebo therapy, which is a sign of improvement in nocturnal enuresis.
BMJManagement of Enuresis
46 Citations1971Sylvia Dische
In 144 enuretic children at four Southwark school health service clinics a good measure of success was achieved by sympathetic handling alone, but the use of drugs needs to be carefully presented and supervised.
Developmental Medicine & Child NeurologyConditioning Treatment of Enuresis
41 Citations1965G.C. Young
Of the 105 cases treated by conditioning, 68 (65 per cent) continued the treatment until cured, the average duration of treatment being 22 months, and the recurrence‐rate was 28 per cent.
Archives of Disease in ChildhoodTreatment of Persistent Enuresis with the Electric Buzzer
37 Citations1958I. G. Wickes
The treatment of enuresis was revolutionized when it was discovered by chance that an apparatus for signalling to the parents that their child had a wet bed and needed changing also had the property of training the child to become dry.
The Journal of UrologyThe Efficacy of Imipramine in the Management of Enuresis
32 Citations1970Samuel A. Kunin, Dean J. Limbert +2 more
Developmental Medicine & Child NeurologyRapidity of Response to the Treatment of Enuresis
29 Citations1973G.C. Young, R.T.T. Morgan
The slow‐response group was characterised by significantly higher levels of anxiety amongst the mothers and a significantly higher incidence of familial disruption and more frequently received drugs in the course of their treatment.
PubMedENURESIS: A THREE-YEAR STUDY OF THE VALUE OF A WAKING APPARATUS.
16 Citations1964J.B.J. McKendry, H. A. Williams +1 more
Since essential enuresis is probably due to an isolated maturational lag, progress in so-called "failures" of treatment can be measured in terms of an increasing initial dry interval between initiation of sleep and first voiding.
Developmental Medicine & Child NeurologyFamilies of Enuretic Children Part I: Family Type and Age Part II: Family Culture, Structure and Organisation
14 Citations1965Zena Stein, Mervyn Susser +1 more
A model of enuretic survivors illustrates that general factors connected with social class seem most relevant to children of an age to enter school, family deviance to pre‐pubertal schoolchildren, and discontinuous family relationships to pubescent children.