الفهرس 
Patients & MethodsOnly 14 pages are availabe for public view
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Abstract
Enuresis is defined as the repeated voiding of urine into clothes or bed at least twice a week for at least 3 consecutive months in a child who is at least 5 yr of age. Primary enuresis occurs in children who have never been consistently dry through the night, whereas secondary enuresis refers to the resumption of wetting after at least 6 months of dryness. Monosymptomatic enuresis has no associated daytime symptoms (urgency, frequency, daytime enuresis), and nonmonosymptomatic enuresis, which is more common, often has at least one subtle daytime symptom. Monosymptomatic enuresis is rarely associated with significant organic underlying abnormalities.
Management of primary nocturnal enuresis may involve one or a combination of interventions as;
I-Non pharmacological therapy
a) Education and reassurance, b) Motivational therapy
c) Behavioral interventions and d) Enuresis alarms
II- Pharmacological:- Currently the mainstays of medical therapy are desmopressin (DDAVP), imipramine and oxybutinin (uripan).
III- Complementary and Alternative Medicine (CAM) (acupuncture)
IV-Treatment of the cause.
A bedwetting alarm is an electronic device used as a treatment option for
nocturnal enuresis. The alarm activates when the wearer urinates. Alarms come in several different styles: wearable alarms, wireless alarms, and pad-type alarms. While there is some variation in the styles of the alarms, they all function similarly; each alarm has a moisture sensor component and an alarm component.
When the child first begins to urinate the sensor will detect the moisture and trigger the alarm. Bedwetting alarms are a treatment tool designed to teach people to respond to a full bladder by waking and using the toilet. This alert helps begin to condition the brain to register the bladder’s need to urinate.
This conditioning of the mind and body is also known as behavior modification. The aim of this work was to evaluate the effectiveness of locally manufactured alarms in treating Egyptian children with mono-symptomatic nocturnal enuresis by measurement of initial success rate compared with international studies.
This study was conducted on 100 primary enuretics (65males & 30 females ) their mean age was (9.35+/-1.75) treated by alarm therapy. According to their initial response (14 consecutive dry nights within 16 weeks of alarm treatment)they were divided into 2 groups:- group A{68%} (those patients who responded initially) and group B{32%} (those patients who failed to attain initial response).Then group A was further divided into A1{85%}(part of group A that continued to attain response after 3month of initial response) and A2{15%} (part of group A who relapsed after 3 month of initial response){Relapse is defined as reappearance of more than 1 wet night /week for responders}.then according to response after 6 month of in initial therapy group A1 further divided into group A1a{88%} (part of group A1 who continued to attain response after 6month of initial response)and A1b{12%}(part of group A1 who relapsed after 6 month of initial response).