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FACT
Focus on Alternative and Complementary Therapies

Complementary Medicine - General

Complementary therapies for bed-wetting: a Cochrane review

Nocturnal enuresis (bed-wetting) is a socially disruptive and stressful condition that affects around 15–20% of 5-year-olds and up to 2% of young adults. The effects of complementary interventions and others such as surgery or diet on nocturnal enuresis in children were assessed and compared with other interventions. The authors searched the Cochrane Incontinence Group Specialised Register, the Traditional Chinese Medical Literature Analysis and Retrieval System and the reference lists of relevant articles. All randomised or quasi-randomised trials of complementary and other miscellaneous interventions for nocturnal enuresis in children were included except for those that focused solely on daytime wetting. Comparison interventions could include no treatment, placebo or sham treatment, alarms, simple behavioural treatment, desmopressin, imipramine and miscellaneous other drugs and interventions. Two reviewers independently assessed the quality of the eligible trials and extracted data. In 15 randomised controlled trials, 1389 children were studied, of whom 703 received a complementary intervention. The quality of the trials was poor: four trials were quasi-randomised, five showed differences at baseline and 10 lacked follow-up data. The outcome was better after hypnosis than imipramine in one trial (RR for failure or relapse after stopping treatment 0.42, 95% CI 0.23–0.78). Psychotherapy appeared to be better in terms of fewer children failing or relapsing than both alarm and rewards but this depended on data from only one trial. Acupuncture had better results than sham control acupuncture in a further trial. Active chiropractic adjustment had better results than sham adjustment. Each of these findings came from small single trials and needs to be verified in further trials.

Glazener CMA, Evans JHC, Cheuk DKL. Complementary and miscellaneous interventions of nocturnal enuresis in children (Review). Cochrane Database Syst Rev 2005; 2: CD005230.
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