The Short- and Long-term Effects of Simple Behavioral Interventions for Nocturnal Enuresis in Young Children: A Randomized Controlled Trial

Objective

To assess the short- and long-term effects of 3 simple behavioral interventions to overcome nocturnal enuresis in young children.

Study design

We performed a randomized controlled trial in children aged four to five years with mono-symptomatic nocturnal enuresis (n = 570). The children were placed in one of four groups: (1) lifting to urinate and ask for a password; (2) the same as group 1, without a password; (3) using a reward system; or (4) a control group. Each participant was asked to carry out the appointed intervention for 6 months or until 14 consecutive dry nights occurred, which was the continence criterion. A follow-up was performed approximately 3 years after the study.

Results

After 6 months, lifting the child to the toilet without the use of a password was the only intervention that resulted in significantly more dry children (37%) than the control group (21%). Three years later, both lifting groups had the highest (78%) and the control group the lowest (69%) percentage of dry children.

Conclusions

The intervention lifting to urinate without the use of a password leads to more dry children compared with no active treatment in children aged 4 to 5 years with nocturnal enuresis.

Abbreviations: DBT, Dry bed training, DSM-IV, Diagnostic and Statistical manual of Mental disorders, NNT, Number needed to treat