Cochrane Summaries

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Simple treatments for bedwetting in children

Caldwell PHY, Nankivell G, Sureshkumar P
Published Online: 
23 July 2013

Bedwetting (nocturnal enuresis) is the involuntary loss of urine at night without an underlying organic disease as the cause. It can result in issues of psychosocial well-being such as social problems, sibling teasing and lowered self esteem. It affects around 15% to 20% of five year olds and up to 2% of adults.

Simple behavioural strategies to help children gain control include star charts and other reward systems, fluid restriction, bladder training (including retention control training) and lifting or wakening. These are often used as a first attempt to control bedwetting and can be undertaken by families with less professional involvement.

The review found 16 trials which involved 1643 children. Most simple behavioural treatments were only studied in single small trials which makes the evidence less reliable. Simple treatments such as rewarding dry nights (e.g. with star charts), lifting and waking and bladder training appeared to be more effective than no treatment but they are not as effective when compared with other treatments known to work, such as enuresis alarm therapy and drug therapy. There does not appear to be one simple behavioural therapy that is more effective than another. On the other hand, simple treatments do not have any side effects or safety concerns. Therefore, simple methods could be tried as first line therapy before considering alarms or drugs for this common childhood condition.

This record should be cited as: 
Caldwell PHY, Nankivell G, Sureshkumar P. Simple behavioural interventions for nocturnal enuresis in children. Cochrane Database of Systematic Reviews 2013, Issue 7. Art. No.: CD003637. DOI: 10.1002/14651858.CD003637.pub3
Assessed as up to date: 
15 December 2011