Interventions for Enuresis in Children and Adolescents: An Overview of Systematic Reviews

Eduarda Correia Moretti; Ivson Bezerra da Silva; Alessandra Boaviagem; Anna Myrna Jaguaribe de Lima; Andrea Lemos

doi:10.2174/1573396318666220827103731

Interventions for Enuresis in Children and Adolescents: An Overview of Systematic Reviews

Curr Pediatr Rev. 2024;20(1):76-88. doi: 10.2174/1573396318666220827103731.

Authors

Eduarda Correia Moretti^{1

2}, Ivson Bezerra da Silva³, Alessandra Boaviagem⁴, Anna Myrna Jaguaribe de Lima⁵, Andrea Lemos⁶

Affiliations

¹ Department of Anatomy, Federal University of Pernambuco, Child and Adolescent Health, Federal University of Pernambuco - Recife (PE), Brazil.
² Institute of Biological and Health Sciences, Federal University of Alagoas (UFAL), Maceió, Alagoas, Brazil.
³ Department of Morphology, Federal University of Paraiba - João Pessoa (PB), Brazil.
⁴ Department of Physiotherapy, Federal University of Pernambuco - Recife (PE), Brazil.
⁵ Department of Animal Morphology and Physiology, Federal Rural University of Pernambuco - Recife (PE), Brazil.
⁶ Department of Physical Therapy, Federal University of Pernambuco, Recife (PE), Brazil.

PMID: 36043721
DOI: 10.2174/1573396318666220827103731

Abstract

Background: Enuresis is an involuntary and intermittent loss of urine during sleep, and its treatment can be done by pharmacological and non-pharmacological strategies.

Objective: To conduct an overview to carry out a survey of the systematic reviews about treatment options for children/adolescents with enuresis.

Methods: Databases used were Cochrane Library, PROSPERO, MEDLINE/PubMed, EMBASE, LILACS/BVS, PEDro, SciELO and Google Scholar. Any type of intervention for the treatment of enuresis in children/adolescents was selected by two independent researchers. Data extraction was done by two independent researchers. The risk of bias was assessed using Risk of Bias in Systematic Reviews (ROBIS) and A MeaSurement Tool to Assess Systematic Reviews (AMSTAR-2).

Results: Seven systematic reviews were included. According to ROBIS, three reviews had a low risk of bias, while the others had a high risk of bias. Based on AMSTAR-2, four systematic reviews were of moderate quality, two were low quality, and one was critically low quality.

Conclusion: There is moderate confidence that the use of desmopressin plus an anticholinergic agent increases the chance of complete response compared to desmopressin alone. Neurostimulation may increase the risk of responses ≥50% and ≥90% compared to the control group. Likewise, it appears that electrical stimulation is superior to placebo about the chance of response ≥50%. In addition, there is clinical relevance in reducing enuresis episodes per week when neurostimulation is used compared to control groups.

Keywords: Enuresis; adolescent; child; evidence-based practice; systematic review; therapeutics.