Treatment of daytime urinary incontinence in children: a systematic review of randomized controlled trials.
OBJECTIVE
We sought to determine the benefits and harms of interventions for children with daytime urinary incontinence.


METHODS
Trials of any interventions for children with primary daytime incontinence (the urge syndrome and/or dysfunctional voiding) were identified from the Cochrane Controlled Trials Register, MEDLINE, EMBASE, reference lists of articles, abstracts from conference proceedings and contact with known experts in the field. Once identified, trial quality was assessed, data were extracted and results were expressed in terms of relative risks (RR) with 95% confidence intervals (CI) for individual trials, and summary estimates were obtained using a random effects model. All steps were done by 2 independent reviewers.


RESULTS
Randomized trials of terodiline (2 studies), daytime alarms (1), imipramine (1) and biofeedback/oxybutynin (1) involving 383 children were reviewed. No intervention was demonstrated to be effective. In the latter trial, which was the only one to evaluate a currently used intervention, after 9 months of treatment there was no difference in the proportions of children with unimproved daytime wetting with oxybutynin (RR 0.74, CI 0.26 to 2.13) and biofeedback (0.92, 0.59 to 1.43) compared with placebo.


CONCLUSIONS
No intervention tested in a trial to date has been proved to be of benefit to children with daytime urinary incontinence.
Sureshkumar
Premala
P
Centre for Kidney Research, Children's Hospital at Westmead, University of Sydney, Westmead, NSW 2145, Australia.
Bower
Wendy
W
Craig
Jonathan C
JC
Knight
John F
JF
D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use; D002082:Butylamines / Q000627:therapeutic use; D002648:Child; D006801:Humans; D007099:Imipramine / Q000627:therapeutic use; D010276:Parasympatholytics / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D014549:Urinary Incontinence / Q000628:therapy*
D018759:Adrenergic Uptake Inhibitors; D002082:Butylamines; D010276:Parasympatholytics; C010637:terodiline; D007099:Imipramine