Chapter

Enuresis

Child and Adolescent Disorders

II. Specific Disorders

  1. W. Larry Williams1,
  2. Marianne Jackson2

Published Online: 25 JUN 2012

DOI: 10.1002/9781118156391.ebcp001016

Handbook of Evidence-Based Practice in Clinical Psychology

Handbook of Evidence-Based Practice in Clinical Psychology

How to Cite

Williams, W. L. and Jackson, M. 2012. Enuresis. Handbook of Evidence-Based Practice in Clinical Psychology. 1:II:16.

Author Information

  1. 1

    University of Nevada, Reno

  2. 2

    California State University, Fresno

Publication History

  1. Published Online: 25 JUN 2012

Abstract

This chapter describes the epidemiology and conditions of enuresis, including diurnal, nocturnal, primary, secondary, and polysymptomatic enuresis. Pharmacological, behavioral, and other interventions for enuresis are described and the relevant literature reporting their effectiveness is reviewed in terms of standard criteria for evidence-based outcomes. Some pharmacological treatments were found to be effective only for the short term. Overall, the urine alarm is an evidence-based practice for the treatment of nocturnal enuresis; however, it is not successful for everyone, and relapse rates are high. In general, the use of retention control training as a stand-alone treatment has been inconsistent in its effectiveness, whereas reinforcement-based procedures alone can be effective in eliminating enuresis. Dry bed training (DBT) meets the requirements for evidence-based treatment with the alarm, and may be effective alone as long as the enuretic is awakened. The literature on DBT suggests that some components may be necessary while others may be less critical to the success of treatment. In general, meta-analyses are not available for complex treatments of enuresis, and conclusions that can only be drawn from small-N experiments indicate that alarm and other interventions such as DBT are more effective than alarm alone but that any treatment with alarms appears better than any treatment without alarms.

Keywords:

  • desmopressin;
  • imipramine;
  • oxybutinin;
  • urine alarm;
  • retention control training;
  • dry bed training;
  • positive practice;
  • positive reinforcement;
  • waking schedule