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Posted On : 03 Mar 2015

what is the most successful treatment for prmary enuresis

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Answer 1

The treatment for primary enuresis that has shown most efficacy is conditioning therapy or alarm therapy.

This method mainly improves the condition by increasing nocturnal bladder capacity or by increasing arousal. Here, a loud auditory or vibratory alarm is attached to a wetness sensor in the underwear.The alarm rings when voiding occurs and is intended to awaken the child, so as to alert them to void. This therapy is considered curative and has a reported success rate of 30-60 percent. Better efficacy is seen in older children. Improvement is seen within the first 2 weeks of treatment for some, while some may require several months. Optimal results are seen when the child and the parents are well motivated. Most children with enuresis do not actually awaken to the alarm, but they do stop emptying the bladder. Follow-up care is important, at least twice a week to sustain motivation, correct technical problems, and to monitor the therapy. If successful, alarm therapy should be continued for at least one month after sustained dryness. Relapses are commonly seen, in 29 percent-66 percent of children. These may respond to further alarm therapy. If bedwetting continues after a minimum of 3 months of consecutive use, therapy can be discontinued and considered unsuccessful.

Other methods of treatment:
1. Motivational therapy- Children should receive a caring and a patient attitude from their parents and the doctor. Never punish the child. If any other family member has had a similar history, then this should be shared with the child. This may help the child to outgrow the problem. Behavioral modification with positive reinforcement may help. Attention should be paid to maintain a normal daytime voiding pattern.

2.Drud therapy-second line-with Desmopressin and imipramine

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