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

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 were 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 the clinical relevance in reducing enuresis episodes per week when neurostimulation is used compared to control groups.