Article

Efficacy of the bell and pad alarm therapy for nocturnal enuresis

The Children's Hospital at Westmead, Westmead, New South Wales, Australia.
Journal of Paediatrics and Child Health (Impact Factor: 1.19). 07/2009; 45(7-8):405-8. DOI: 10.1111/j.1440-1754.2009.01528.x
Source: PubMed

ABSTRACT (i) To determine the efficacy of bell and pad alarm therapy as an initial and relapse treatment for nocturnal enuresis; (ii) to explore risk factors for treatment failure; and (iii) to explore risk factors for relapse within 12 months of successful bell and pad alarm therapy.
A 22-item questionnaire was sent to 240 children who received bell and pad alarm therapy in a 6-year period via a community centre. The questionnaire recorded demographic characteristics of the child, length of the first bell and pad alarm therapy, outcome of initial treatment and relapse information.
The initial response and relapse rates of bell and pad alarm therapy were 84 and 30%, respectively. Female gender, absence of diurnal symptoms and willingness to use alarm therapy were associated with better treatment outcomes. Treatment success was associated with shorter treatment length. The success rate of repeating alarm therapy after relapse was 78%, with an average length of treatment of 10 weeks.
The bell and pad alarm therapy is an effective treatment for nocturnal enuresis both as initial therapy and after relapse. The association between patient characteristics and treatment response found in our study may help inform clinicians of likely treatment outcomes, and identify those who may need a different approach.

Download full-text

Full-text

Available from: Patrina Caldwell, Jul 07, 2015
0 Followers
 · 
89 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Enuresis nocturna is a widespread problem among children, with up to 25% of all children possibly suffering from this condition. Several therapeutic modalities are currently available. This article reviews current state-of-the-art therapies, highlights current literature, and provides an update on recent developments within the field of enuresis nocturna.
    Reviews in urology 01/2011; 13(1):1-5.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: RESUMO Foi realizado levantamento das características sociodemográficas e clínicas da população que procura tratamento para enurese em um centro de atendimento psicológico a esse transtorno e quais as estratégias de enfrentamento familiar mais frequentes diante dos episódios de "molhadas", em casos de enurese noturna primária. Foram realizadas análises descritivas dos prontuários de 185 crianças (6-11 anos) e 55 adolescentes (12-18 anos), de ambos os sexos, triados entre 2004 e 2009, dos quais foram extraídas informações sobre: variáveis sociodemográficas e clínicas, bem como sobre estratégias de enfrentamento familiar. O predomínio de uma frequência superior a seis "molhadas" semanais foi identificado em crianças e adolescentes (70,6% e 50%). Observou-se ainda predominância do sexo masculino (67,9%), de população infantil (77,1%) e de famílias de classe média. Quando a família havia buscado tratamento anterior, o tratamento medicamentoso revelou-se prioritário entre crianças (28,7%) e adolescentes (47,1%). Diante dos episódios enuréticos, as estratégias de minimização dos danos e prevenção mais utilizadas, para ambos os grupos, foram: o uso de fralda ou protetor de colchão e acordar a criança para ir ao banheiro. Punição foi declarada por apenas 15,4% dos pais de crianças e 17,3% de adolescentes. Os dados revelaram que o baixo índice de clientes de classes socioeconômicas desfavorecidas constitui um desafio para o serviço que busca atender a todas as faixas econômicas e o fardo trazido pela enurese parece impelir as famílias a procurarem alternativas ou outros tratamentos para sanar o problema quando a primeira intervenção clinica não é satisfatória. Palavras-chave: psicologia, enurese, características da população, diagnóstico, tratamento. ABSTRACT This work aimed to identify sociodemographic and clinical characteristics of population who look for enuresis treatment in a university care center for this disorder and to identify the most used familiar coping strategies facing the episodes of “wet” in cases of primary nocturnal enuresis. Descriptive analyses of medical files were performed from 185 children (6-11 years old) and 55 adolescents (12-18 years old), from both sexes, screened between 2004 and 2009, whose extracted information were: sociodemographic and clinical data as well as family coping strategies. High frequency of “wet night” over six weekly was identified in children and adolescents (70.6% and 50%). There was a male (67.9%) prevalence of a child population (77.1%) from middle-class families. When the family looked for previous treatment, medication treatment proved to be the priority among children (28.7%) and adolescents (47.1%). More frequent strategies facing enuretic episodes for minimizing damage and preventing bed wetness in both age groups were: using diapers or protective mattress and waking the child to go to the bathroom. Punishment was declared by only 15.4% of parents of children and 17.3% of adolescents. The data showed that the low incidence of disadvantaged families in the service constitutes a challenge since the philosophy of the service is attending all economic tracks, and the burden brought by enuresis seems to push families into searching for alternatives to solve the problem when the first response to clinical treatment is not satisfactory.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Metabolic Syndrome (MS) increases the risk of developing type-2 diabetes (DM2) and cardiovascular diseases (CVD) and it is thought to be prevalent in Nigeria. This study aims at determining the prevalence of MS and its component risk factors among apparently healthy traders in a local market in Ibadan, Nigeria. Methods: 534 apparently healthy traders from a local market in Bodija, Ibadan, Nigeria aged (18–105) years with neither DM2 nor CVD were participants of a cohort study on risk assessment of type 2 diabetes and dementia in Nigerians with metabolic syndrome. The International Diabetes Federation (2005) and the World Health Organisation (1998) criteria were used for MS and BMI respectively. Anthropometric indices (weight, height, body mass index (BMI), percentage body fat (PBF), waist and hip circumferences (WC & HC) and their ratio (WHR), waist circumference to height ratio (WHT)) and blood pressure (BP) were obtained by standard methods. Blood samples (6 ml) were obtained for the determination of glucose (FPG), total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C) by enzymatic methods while low density lipoprotein cholesterol (LDL-C) was calculated. Descriptive statistics, Chi-square test and ANOVA were among the analyses conducted. Results: 301 (56.4%) of traders studied were overweight (176, 33.0%) or obese (125, 23.4%) while 17 (3.4%) and 125 (40.4%) were underweight and normal weight respectively. The prevalence of MS and obesity were 87 (16.3%) and 125 (23.4%) respectively. There was significant association between obesity and MS (p < 0.05). Both MS and obesity were significantly associated with gender (p < 0.05). The prevalence of MS and obesity was higher in female (20.9%; 31.0%) than male traders (6.5%; 7.1%) respectively. The prevalence of MS increased from normal weight (8.3%) to overweight (18.8%) to obesity (28.8%). There were significantly higher differences in age, BP(systolic and diastolic), weight, BMI, WC, HC, WHT, WHR, and PBF but lower difference in height when overweight/obese groups were compared with normal weight group (p < 0.05). TC and LDL-C were significantly higher in only obese than normal weight traders. However, FPG, TG and HDL-C were similar in all groups (p > 0.05). Conclusion: There is high prevalence of MS and obesity among Nigerian traders. Female gender, hypercholesterolemia, hypertension, increasing age, general and abdominal obesity appear to be important metabolic risk factors of CVD and not DM2 among Nigerian traders. Health care strategies for effective modulation of diet and lifestyle are needed urgently. In addition, screening programs for indices of MS in all Nigerians irrespective of BMI could be considered.