II. Indications

  1. Nocturnal Enuresis (Bed wetting) at least 1-2 times weekly typically in a child age 6 years and older

III. Preparations: Devices

  1. Bell, light, vibrator, or buzzer and Pad (Alarm)
  2. Alarms when device becomes wet
    1. Acoustic devices emit a loud sound
  3. Bed alarms that wake the child (instead of the parent) are most effective
  4. Children prefer body-worn bed alarms over bed pads
  5. Do not use electric shock alarms!

IV. Efficacy

  1. Higher success rate (75%) than medications
  2. Least relapse rate after therapy is stopped (41%)
  3. Most effective in children age >6 years with frequent Nocturnal Enuresis (at least weekly) and in highly motivated families

V. Advantages

  1. Best efficacy of any method in Nocturnal Enuresis (better than Desmopressin and Imipramine)
  2. Low initial cost ($100) compared with medications
  3. Alarm may be covered by insurance
  4. Vibratory alarms are available for Hearing impaired

VI. Disadvantages

  1. Requires use often for up to 15 weeks for full effect
    1. Reevaluate at 2-3 weeks after starting
    2. Consider other therapy if no effect by 6 weeks (consider re-trial every 2 years despite failed prior trial)
    3. May discontinue after 2 weeks of consecutive dry nights (restart if relapse)
  2. High drop-out rate (10-30%)
  3. Bed wetting should be at least 1-2 nights weekly to be warranted
  4. Parents and children must be motivated for success
    1. Parents often need to sleep in same room with child initially to assist awakening to the alarm
    2. Child may need to be awakened and carried to bathroom to finish voiding

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Ontology: Nocturnal bladder warning system (C0178997)

Definition (UMD) Alarms designed to activate a visual or more frequently audible (e.g., a buzzer sound) alarm when wetness caused by an involuntary small discharge of urine during sleep (i.e., enuresis) is detected. These devices typically consist of a humidity sensor that is attached to a pad, sheet, or the underwear of a patient (usually a child), an electronic unit, and an audible alarm located on or near the bed. When a child begins to wet the bed an alarm is triggered and wakes the child who can finish urinating in the toilet. Enuresis (also known as bed wetting) alarms are used mainly to facilitate a behavior modification treatment intended to get control of the urinary bladder in otherwise healthy children; they may be also used in geriatric/long-term care settings to manage incontinence.
Definition (SPN) An enuresis alarm is a device intended for use in treatment of bedwetting. Through an electrical trigger mechanism, the device sounds an alarm when a small quantity of urine is detected on a sensing pad. This generic type of device includes conditioned response enuresis alarms.
Concepts Medical Device (T074)
SnomedCT 183230003, 151454009, 271524000
English ALARM, CONDITIONED RESPONSE ENURESIS, Incontinence Alarms, Nocturnal bladder warning syst, Alarms, Enuresis, Bedwetting Alarms, Enuresis Alarms, Nocturnal bladder warning system, alarms bedwetting, alarm bedwetting, bedwetting alarms, enuresis alarms, alarm enuresis, enuresis alarm, bedwetting alarm (treatment), bedwetting alarm, Nocturnal bladder warning system (procedure), Enuresis alarm, Enuretic alarm, Nocturnal bladder warning system (physical object)
Spanish alarma para enuresis, alarma para enuréticos, sistema de alarma vesical nocturna (objeto físico), sistema de alarma vesical nocturna