title: Behavioral therapy for primary nocturnal enuresis.
abstract: OBJECTIVE
  Recent studies suggest the efficacy of behavioral therapy for enuresis, even in cases of minor daytime voiding problems. We describe our experience with the clinical followup and behavioral therapy of children with primary enuresis.
  
  
  METHODS
  We followed 159 boys and 91 girls 5 to 17 years old with primary enuresis who were treated at 3 medical centers with a pediatric nephrology clinic during the last 3 years. A detailed voiding history was obtained. Each child was treated with a bladder training session, including an explanation of the enuretic process, daily diary recording and training to recognize bladder distention and increase voiding frequency.
  
  
  RESULTS
  A total of 226 children (90%) presented with 1 or more symptoms of bladder maturation delay and 13% reported behavioral constipation. Of the patients 185 (74%) completed the proposed treatment, including 111 (60%) who reported a positive and 21 (11%) who reported a partial response. In 53 children (29%) the treatment failed.
  
  
  CONCLUSIONS
  Most children with enuresis have daytime symptoms when an accurate history is recorded. As shown by our data, the efficacy of behavioral therapy is comparable to that of desmopressin or alarm therapy but it requires good compliance of the child with the therapeutic plan. Age is not a determining factor in the success rate.
authors.affiliation: Pediatric Department, IRCCS Burlo Garafolo, University of Trieste, Italy. pennesi@burlo.trieste.it
authors.forename: Marco
authors.initials: M
authors.lastname: Pennesi
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pitter
authors.forename: Andrea
authors.initials: A
authors.lastname: Bordugo
authors.forename: Silvia
authors.initials: S
authors.lastname: Minisini
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Peratoner
mesh_terms: D000293:Adolescent; D001521:Behavior Therapy; D002648:Child; D002675:Child, Preschool; D004775:Enuresis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male