Bedwetting Alarm vs Medication for Long Term Success

My pediatrician mentioned that there are two evidence-based treatments for bedwetting: medication and bedwetting alarms.  We want something that is successful but lasts.  Is there any research about this?

There are many studies that compare these two bedwetting treatments.  A recent one was published in Journal of Pediatric Urology October 2020.  Here is a summary.

Study Design

Group 1 average age 11.2 years    Desmopressin Melt group

Group 2 average age 10.2 years    Enuresis Alarm

Response was evaluated at 4, 12 and 24 weeks of treatment.

Results

The response rate was similar at week 4 and 12 but the complete response rate was significantly higher in the enuresis alarm group (64.9%) than in the desmopressin group (41.3%) at the end of the study (24 weeks).

The other significant difference was the relapse rate after the treatment was stopped.  The relapse rate was almost half (48.9%) in the desmopressin group vs 20.5% in the enuresis alarm group.

Discussion

Medication can provide a quick response but this study proves, once again, that most of the children start wetting again when the medicine is stopped.  Parents are often reluctant to put their child on medication to begin with, but you should know that the wetting returns on the nights there is no medication.  In other words, medication does not provide a permanent or long-lasting cure.  Medication can be useful for overnight stays or camps with the knowledge that the wetting restarts when the medicine is stopped.

Bedwetting alarms do require time and parent and child participation.  But the effort involved pays off with a higher response rate and a lower relapse rate.  Once the bedwetting alarm is stopped after 14 dry nights, the majority of children stay dry.