Abstract General Information

Title

ENURESIS ALARM FOR TREATMENT OF URINARY INCONTINENCE IN CHILDREN WITH COMBINED DAYTIME INCONTINENCE AND ENURESIS (THE ABDE-STUDY)

Introduction and objective

A significant number of incontinent children suffers from combined daytime incontinence and enuresis. Urotherapy is recommended as first line treatment and after resolution of daytime symptoms enuresis alarm is first line method for gaining nocturnal bladder in children without nocturnal polyuria. Whether nighttime use of the enuresis alarm influence daytime symptoms is unclear.
The objective of this randomized controlled multisite study was to examine the effect of nighttime enuresis alarm as ad-on to standard urotherapy as first line treatment for both daytime urinary incontinence and enuresis.

Method

Children with combined daytime incontinence and enuresis were randomized to 8 weeks treatment with either nighttime enuresis alarm and timer watch assisted urotherapy (alarm-group) or solely timer watch assisted urotherapy (control-group).

Results

Eighty-five children were included with mean age 7.16±1.50 years, there was no age-difference between the two groups. The two groups experienced equal number of wet days per week at baseline (mean 5.6 days per week). With regards to reducing daytime incontinence the combination of urotherapy and enuresis alarm was significant more effective than standard urotherapy alone (delta score wet days per week alarm-group: 1.7 vs control-group: 0.4 p=0.019). Moreover, the combination of urotherapy and nighttime alarm had a significant effect on enuresis, whereas 73% of the children in the alarm-group had at least 50% reduction in their wet nights per week and 37% became completely dry at night. Correspondently none of the children receiving standard urotherapy (control-group) obtained 50% or more reduction in their enuresis.

Conclusion

This study shows that an enuresis alarm at nighttime reduces both daytime incontinence and enuresis in children with combined enuresis and daytime incontinence. Also, there seems to be no need to handle daytime incontinence before enuresis in these children, even the enuresis alarm treatment may be a valuable ad-on to urotherapy as first line treatment of combined daytime urinary incontinence and enuresis in children