A Mayo Clinic study has found that the urine alarm method of stopping nocturnal enuresis, commonly known as bedwetting, offers the most promise to solve this common childhood problem.
Bedwetting is defined as repeated urination into bed or clothes, occurring twice per week for at least three consecutive months, in a child of at least five years of age and not due to either a drug side effect or a medical condition.
The study reviewed over 30 years of nearly 70 well-controlled outcome studies on psychological and behavioral interventions.
"This study allows us to recognize the effectiveness of an old and well-documented device - the urine alarm - as a solution to this common childhood problem," says Michael Mellon, Ph.D., a Mayo Clinic child psychologist and director of the Mayo Clinic Enuresis Clinic.
The alarm works via its sensitivity to moisture. The child is awakened by a sound not unlike a typical alarm clock. Though there are various types of urine alarms, all prove equally effective to stop bedwetting.
Bedwetting, or nocturnal enuresis, occurs in approximately 10 percent of children six to seven years of age, making it a common problem among children. Generally, bedwetting occurs when there is a delay in the developmental process of learning to use bathroom facilities and understanding the process of being dry. Though often due to genetic influences, bedwetting can be caused when children have smaller than normal bladders, when too much urine is processed and when the bladder has spastic contractions.
The findings can mean the difference in a three- to four-month treatment with a 75 percent rate of success versus the typical three- to four-year treatment when using drug therapies to eliminate the problem. The most popular method of bedwetting treatment is the use of antidepressant drugs,
which work in approximately 50 percent of the cases but maintain a high relapse rate in young patients. Most patients would typically outgrow the problem before the drug therapy would have a permanent effect.
"This is a learning-based approach to this very common problem," says Mellon. "Parents and their child must work as a team to accomplish the goal of remaining dry overnight. This method has been around since 1938, but unfortunately, it - unlike drug therapies - is not often covered by insurance. And though itís more effective and less expensive, itís not often remembered as a viable option for stopping this problem." The reasons why an empirically supported treatment for such a common problem is not promoted by healthcare providers and supported by the health insurance industry through reimbursement remains unclear. In ideal circumstances, a patient and their parents would work with both a pediatrician (or family physician) and a psychologist to treat the nocturnal enuresis.