High short-term effectiveness of modulated dry bed training in adolescents and young adults with treatment-resistant enuresis

Hypothesis/aims of study Two percent of adolescents and adults suffers from enuresis. In this age group, social problems can arise. We evaluated the effect of a Modulated Dry Bed Training (MDBT) in a previously therapy-resistant group of adolescents and adults with enuresis, provided by a specialized enuresis-centre. Study design, materials and methods Descriptive, retrospective cohort study. Between January 2003 and July 2013, 907 patients were treated by MDBT: a 5-days/4- nights in-hospital training in small groups consisting of enuresis-anamnesis, explanation, alarm treatment, day-time activities with the purpose of increasing self-esteem and group contact. We contacted patients by phone during follow-up. Patient data were retrospectively derived from medical files and put in a database. Success of treatment was determined using International Children's Continence Society (ICCS)-definitions, at 6 weeks, 3 and 6 months. Secondary outcome was the medication use after treatment. Sensitivity analyses were performed to control for missing values, and expressed in a best case and a worst case scenario. Results Patients were aged 11-42 years (median 15, IQR 3.5), 34% female. At baseline, 65% had primary enuresis, 81% nonmonosymptomatic enuresis, and 46% frequent enuresis (≥4 days/week). After 6 weeks, 46% (CI95% 43-50) and 41% of patients had a full or partial response, respectively. After 6 months this was 68% (CI95% 65-72) and 25%. Results from the sensitivity analysis are shown in the table. Interpretation of results The treatment response at six months can be considered to be quite high, as this is a formerly therapy-resistant group of enuresis patients. However, the sensitivity analysis shows that, owing to the large amount of missing values, the real number of patients having a full response after six months will lie between 43% and 80%. Concluding message MDBT was shown to have an adequate short term effect in therapy resistant adolescents and adults with enuresis. (Table Presented)