title: The efficacy of alarm therapy versus desmopressin therapy in the treatment of primary mono-symptomatic nocturnal enuresis: a systematic review.
abstract: OBJECTIVE
  To investigate the efficacy of alarm therapy versus desmopressin therapy in treating primary mono-symptomatic nocturnal enuresis (PMNE).
  
  
  BACKGROUND
  PMNE is a common childhood disorder, which if left untreated can have a significant impact on a child's self-esteem and behaviour. Alarm therapy and desmopressin therapy are the two main treatments currently available in UK-based nurse-led enuresis clinics.
  
  
  METHODS
  A systematic review of the literature was undertaken to assess the efficacy of PMNE treatments. Following application of inclusion/exclusion criteria eight randomised controlled/clinical trials were identified involving children aged 5-17 years with PMNE receiving either alarm therapy or desmopressin therapy.
  
  
  RESULTS
  Seven studies found no statistical difference in nocturnal continence improvement between the two interventions at the point when treatment was stopped. Four studies had a significantly larger relapse rate of nocturnal enuresis with desmopressin compared with alarm therapy when the treatment was withdrawn. Two papers reported that those participating in the alarm therapy intervention of the trials had a higher attrition rate than the desmopressin intervention. The overall findings from the eight studies showed that long term alarm therapy was more effective in treating nocturnal enuresis than desmopressin therapy. The review found that families and children receiving the alarm therapy intervention require more support from health care professionals to comply with treatment than those receiving the desmopressin therapy. However, if nurse-led clinics can support families to persist with the alarm therapy intervention, they are more likely to experience longer term improvement in continence.
authors.affiliation: 1School Nurse,Guy's and St Thomas' NHS Foundation Trust.
authors.forename: Nina
authors.initials: N
authors.lastname: Perrin
authors.affiliation: 2Lecturer,Department of Postgraduate Research,King's College London,London,UK.
authors.forename: Lynn
authors.initials: L
authors.lastname: Sayer
authors.affiliation: 3Professor of Community Nursing,King's College London,London,UK.
authors.forename: Alison
authors.initials: A
authors.lastname: While
mesh_terms: D000293:Adolescent; D050034:Antidiuretic Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D056902:Clinical Alarms; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use*; D006801:Humans; D053206:Nocturnal Enuresis / Q000188:drug therapy / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D050034:Antidiuretic Agents; D003894:Deamino Arginine Vasopressin