Efficacy of the bell and pad alarm therapy for nocturnal enuresis.

AIM (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. METHODS 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. RESULTS 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. CONCLUSION 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.