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National Clinical Guideline Centre (UK). Nocturnal Enuresis: The Management of Bedwetting in Children and Young People. London: Royal College of Physicians (UK); 2010. (NICE Clinical Guidelines, No. 111.)

Appendix BKey Clinical Questions and Search Strategies

Background link between the scope and questions

Questions listed have been developed in relation to the clinical areas covered in the NICE NE guideline scope. Each question has been written to cover a specific dimension of an area in the scope. The questions have been developed by the technical team in consultation with the clinical advisor who has provided guidance on wording and clinical relevance of the specific questions.

The questions are structured according to the PICO format, i.e. they consist of the population, intervention(s), comparison(s), and outcome(s) of interest to the guideline developers. The purpose of formatting questions in this style is so that structured literature searches of relevant electronic databases (e.g. Medline, Embase, CINAHL) can be developed by information scientists in order to identify relevant research studies.

Each question is essentially a topic for an individual systematic review conducted during the development phase of the guideline. Questions shaded in grey are to be combined and those in light blue are confirmed.

Clinical QuestionType of StudyPopulationInterventionComparatorProposed Outcome
Assessment
What are the core elements of initial clinical history and examination, in the evaluation of children and young people under 19 years old who have nocturnal enuresis (bedwetting) ?

General evidence review on assessment.
Non-RCT studiesChildren and young people under 19 years old who have nocturnal enuresis (bedwetting)
Sub group to include patients with:

Special needs (learning disabilities, emotional and ADHD)
History taking and examinationNoneExcluding secondary causes

Establish pattern of wetting to include:

Overactive bladder

Constipation
What are the core laboratory urine/blood tests in the evaluation of children and young people under 19 years old who have nocturnal enuresis (bedwetting) ?
General evidence review on assessment
Non-RCT studiesChildren and young people under 19 years old who have nocturnal enuresis (bedwetting)Laboratory urine/blood testsNone

Other diagnostic tool
Excluding secondary causes

Establish pattern of wetting to include

Overactive bladder
What is the incremental benefit and cost effectiveness of radiological examination, in the evaluation of children and young people under 19 years old who have nocturnal enuresis (bedwetting) ?

General evidence review on assessment
Non-RCT studiesChildren and young people under 19 years old who have nocturnal enuresis (bedwetting)

Therapy resistant children

Daytime symptoms

UTI

Constipation
Radiological examinations (e.g. ultrasound)None

Other diagnostic tool
Excluding secondary causes

Establish pattern of wetting to include

Overactive bladder
What are the core elements of bladder diaries and other assessment tools, in the evaluation of children and young people under 19 years old who have nocturnal enuresis?

General evidence review on assessment
Non-RCT studiesChildren and young people under 19 years old who have nocturnal enuresis (bedwetting)Bladder diaries and other toolsNone

Other diagnostic tool
Excluding secondary causes

Establish pattern of wetting to include

Overactive bladder
How should a psychological assessment be conducted, in the evaluation of children and young people under 19 years old who have nocturnal enuresis (bedwetting) ?
General evidence review on assessment
Non-RCT studiesChildren and young people under 19 years old who have nocturnal enuresis (bedwetting)Psychological assessmentNone

Other diagnostic tool
Excluding secondary causes

Establish pattern of wetting to include

Overactive bladder
Support and follow up/relapse preventionRCT for general NE (bedwetting)population

Non-RCT studies (CCT, cohort level) for subgroup data.
What is the clinical and cost effectiveness of support and follow up care for children and young people under 19 years old who have nocturnal enuresis (bedwetting) ?

No evidence indentified
RCT for general NE population

Non-RCT studies (CCT, cohort level) for subgroup data.
Children and young people under 19 years old who have nocturnal enuresis (bedwetting)
Sub groups to include patients with:

Day time symptoms

Young (under 7 years)

Special needs (learning disabilities, emotional and ADHD)

Severe wetting (6–7 nights a week)

Previously successful and with subsequent relapse
Support and follow up for patientsNo support or follow upContinued success

Relapse prevention

Psychological effects(self-esteem, self-concept, PinQ)
Quality of life measure
Drop out
What is the clinical and cost effectiveness of support and follow up care for the parents and carers of children and young people under 19 years old who have nocturnal enuresis (bedwetting) ?

No evidence indentified
RCT for general NE population

Non-RCT studies (CCT, cohort level) for subgroup data.
Children and young people under 19 years old who have nocturnal enuresis (bedwetting)
Sub groups to include patients with:

Day time symptoms

Young (under 7 years)

Special needs (learning disabilities, emotional and ADHD)

Severe wetting (6–7 nights a week)

Previously successful and with subsequent relapse
Support and follow up for parents and carers

Support groups
No support or follow upContinued success

Relapse prevention

Psychological effects(self-esteem, self-concept, PinQ)

Quality of life measure

Drop out
What is the clinical and cost effectiveness of relapse prevention strategies for children and young people under 19 years old who have nocturnal enuresis (bedwetting)?

No evidence indentified
RCT for general NE (bedwetting)population

Non-RCT studies (CCT, cohort level) for subgroup data.
Children and young people under 19 years old who have nocturnal enuresis (bedwetting)
Sub groups to include patients with:

Day time symptoms

Young (under 7 years)

Special needs (learning disabilities, emotional and ADHD)

Severe wetting (6–7 nights a week)

Previously successful and with subsequent relapse
Relapse prevention strategies ( e.g. follow-up, over-learning specifically to alarms, intermittent use, sudden or slow withdrawal)

Drug or alarm
No relapse prevention strategiesContinued success

Relapse prevention

Psychological effects(self-esteem, self-concept, PinQ)

Quality of life measure

Drop out
What is the clinical and cost effectiveness of treating relapses in previously successful in children and young people under 19 years old who have nocturnal enuresis (bedwetting) ?

No evidence indentified
RCT for general NE (bedwetting)population

Non-RCT studies (CCT, cohort level) for subgroup data.
General NE (bedwetting) population
What is clinical and cost effectiveness of additional investigation and treatment in children who have not responded to an adequate trial of both desmopressin and or alarms?RCT for general NE population (bedwetting)

Non-RCT studies (CCT, cohort level) for subgroup data.
Children and young people under 19 years old who have nocturnal enuresis (bedwetting)who have been unsuccessful in previous treatments
Sub groups to include patients with:

Day time symptoms

Young (under 7 years)

Special needs (learning disabilities, emotional and ADHD)

Severe wetting (6–7 nights a week)
Psychological assessments

Radiological investigations

Treatment for second time-query any other treatments
Reduction/change in number of wet nights

Dry for 14 consecutive nights

Dry for 6 consecutive months (continuing success)

Dry for 2 consecutive years?

Adverse events

Psychological effects (self-esteem, self-concept, PinQ)

Quality of life measure

Drop-outs
Patient ChoiceTo consider special needs children
In children and young people with nocturnal enuresis (bedwetting), how does patient or parent/carer choice over treatment intervention influence treatment outcomes?

Evidence Review
Survey, InterviewsChildren and young people under 19 years old who have nocturnal enuresis (bedwetting)
Sub groups to include patients with:

Day time wetting, urinary urgency and frequency

No day time symptoms (monossymptomatic NE)

Nocturnal Poliuria-large amounts of dilute urine in the first 1/3 of the night.

Young (under 7 years)

Special needs (learning disabilities, emotional and behavioural e.g. ADHD)

Secondary onset

Severe wetting (6–7 nights a week)

Family history

Previously successful with alarm and with subsequent relapse
Patient and carer choicePatient choice compared to parent/care r choice compared to clinician choiceReduction/change in number of wet nights

Dry for 14 consecutive nights

Dry for 6 consecutive months (continuing success)

Dry for 2 consecutive years?

Adverse events

Psychological effects (self-esteem, self-concept, PinQ)

Quality of life measure

Drop-outs
Looking for patient preference trials, otherwise extrapolations, narrative etc.
Family Impact
What is the family impact of children and young people aged under 19 who have Nocturnal Enuresis (bedwetting)?

Evidence Review
Surveys, InterviewsAll groups
Under 5 Year olds
What are the predictive, prevention, and treatment options for under 5 year olds?

Evidence Review
RCT for general NE
(bedwetting)population

Non-RCT studies (CCT, cohort level) for subgroup data
General NE (bedwetting)population

Bladder dysfunction
Complex behavioural
What is the clinical and cost effectiveness of dry bed training for children and young people under 19 years old who have nocturnal enuresis (bedwetting)?

Evidence Review
RCT for general NE (bedwetting)population

Non-RCT studies (CCT, cohort level) for subgroup data.
Children and young people under 19 years old who have nocturnal enuresis (bedwetting)
Sub groups to include patients with:

Day time wetting, urinary urgency and frequency

No day time symptoms (monossymptomatic NE)

Nocturnal Poliuria-large amounts of dilute urine in the first 1/3 of the night.

Constipation

Young (under 7 years)

Special needs (learning disabilities, emotional and behavioural e.g. ADHD)

Secondary onset

Severe wetting (6–7 nights a week)

Family history

Previously successful with alarm and with subsequent relapse
Dry bed training

Core components:
-

regular waking

-

drinking

-

with or without alarm

(will need to further define but from Cochrane reviews: waking each hour, cleanliness training, positive practice)
Full spectrum training (alarm with retention control, overlearning, cleanliness training)
No treatment

Alarms

Other treatment
Reduction/change in number of wet nights

Dry for 14 consecutive nights

Dry for 6 consecutive months (continuing success)

Dry for 2 consecutive years?

Adverse events

Psychological effects (self-esteem, self-concept, PinQ)

Quality of life measure

Drop-outs
Simple behavioural
What is the clinical and cost effectiveness of bladder training / retention control training for children and young people under 19 years old who have nocturnal enuresis (bedwetting)?

Evidence Review
RCT for general NE (bedwetting)population

Non-RCT studies (CCT, cohort level) for subgroup data
Children and young people under 19 years old who have nocturnal enuresis (bedwetting)
Sub groups to include patients with:

Day time wetting, urinary urgency and frequency (polissymptomatic)

No day time symptoms (monossymptomatic NE)

Nocturnal Poliuria-large amounts of dilute urine in the first 1/3 of the night.

Constipation

Young (under 7 years)

Special needs (learning disabilities, emotional and behavioural e.g. ADHD)

Secondary onset

Severe wetting (6–7 nights a week)

Family history

Previously successful with alarm and with subsequent relapse
Daytime bladder training

Retention control training
No treatment

Other treatment
Reduction/change in number of wet nights

Dry for 14 consecutive nights

Dry for 6 consecutive months (continuing success)

Dry for 2 consecutive years?

Adverse events

Psychological effects (self-esteem, self-concept, PinQ)

Quality of life measure

Drop-outs
What is the clinical and cost effectiveness of fluid and dietary advice for children and young people under 19 years old who have nocturnal enuresis (bedwetting)?

Evidence Review
RCT for general NE (bedwetting) population

Non-RCT studies (CCT, cohort level) for subgroup data
Children and young people under 19 years old who have nocturnal enuresis (bedwetting)
Sub groups to include patients with:

Day time wetting, urinary urgency and frequency (polissymptomatic)

No day time symptoms (monossymptomatic NE)

Nocturnal Poliuria-large amounts of dilute urine in the first 1/3 of the night.

Constipation

Young (under 7 years)

Special needs (learning disabilities, emotional and behavioural e.g. ADHD)

Secondary onset

Severe wetting (6–7 nights a week)

Family history

Previously successful with alarm and with subsequent relapse
Night time fluid restriction

Increasing day time fluids

Diet advice

Diet or food restriction
No treatment

Other treatment
Reduction/change in number of wet nights

Dry for 14 consecutive nights

Dry for 6 consecutive months (continuing success)

Dry for 2 consecutive years?

Adverse events

Psychological effects (self-esteem, self-concept, PinQ)

Quality of life measure

Drop-outs
What is the clinical and cost effectiveness of star charts and other reward systems for children and young people under 19 years old who have nocturnal enuresis (bedwetting)?

Evidence Review
RCT for general NE (bedwetting) population

Non-RCT studies (CCT, cohort level) for subgroup data
Children and young people under 19 years old who have nocturnal enuresis (bedwetting)
Sub groups to include patients with:

Day time wetting, urinary urgency and frequency (polissymptomatic)

No day time symptoms (monossymptomatic NE)

Nocturnal Poliuria-large amounts of dilute urine in the first 1/3 of the night.

Young (under 7 years)

Special needs (learning disabilities, emotional and behavioural e.g. ADHD)

Secondary onset

Severe wetting (6–7 nights a week)

Family history

Previously successful with alarm and with subsequent relapse
Star charts and other reward systemsNo treatment

Other treatment
Reduction/change in number of wet nights

Dry for 14 consecutive nights

Dry for 6 consecutive months (continuing success)

Dry for 2 consecutive years?

Adverse events

Psychological effects (self-esteem, self-concept, PinQ)

Quality of life measure

Drop-outs

Behaviour changes
Alarms
What is the clinical and cost effectiveness of alarms for children and young people under 19 years old who have nocturnal enuresis (bedwetting)?

Evidence Review
RCT for general NE (bedwetting) population

Non-RCT studies (CCT, cohort level) for subgroup data
Children and young people under 19 years old who have nocturnal enuresis (bedwetting)
Sub groups to include patients with:

Day time wetting, urinary urgency and frequency (polissymptomatic)

No day time symptoms (monossymptomatic NE)

Nocturnal Poliuria-large amounts of dilute urine in the first 1/3 of the night.

Young (under 7 years)

Special needs (learning disabilities, emotional and behavioural e.g. ADHD)

Secondary onset

Severe wetting (6–7 nights a week)

Family history

Previously successful with alarm and with subsequent relapse
Alarm alone (body worn, bed, vibrating, wireless, voice recorded, multi-tone, bell and pad)No treatment;

Alarm and drugs (Desmopressin, Imipramine, amitriptyline, nortriptaline, anticolinergic oxybutinin, long-acting tolterodine)

Drugs (Desmopressin, Imipramine, amitriptyline, nortriptaline, anticolinergic oxybutinin, long-acting tolterodine)

Other treatment; Alarm with behavioural treatment (dry bed training)

Complementary therapies

Standard advice/care

Alarm and support
Reduction/change in number of wet nights

Dry for 14 consecutive nights

Dry for 6 consecutive months (continuing success)

Dry for 2 consecutive years?

Adverse events (sleep disruption, false alarms, drop-outs)

Psychological effects (self-esteem, self-concept, PinQ)

Quality of life measure

Drop-outs
Drugs
What is the clinical and cost effectiveness of desmopressin (nasal, tablets and melts) for children and young people under 19 years old who have nocturnal enuresis (bedwetting)?

Evidence Review
RCT for general NE (bedwetting) population

Non-RCT studies (CCT, cohort level) for subgroup data
Children and young people under 19 years old who have nocturnal enuresis
Sub groups to include patients with:

Day time wetting, urinary urgency and frequency (polissymptomatic)

No day time symptoms (monossymptomatic NE)

Nocturnal Poliuria-large amounts of dilute urine in the first 1/3 of the night.

Young (under 7 years)

Children with sickle cell disease

Special needs (learning disabilities, emotional and behavioural e.g. ADHD)

Secondary onset

Severe wetting (6–7 nights a week)

Family history

Previously successful with alarm and with subsequent relapse
Desmopressin Nasal, tablets and melts (N.B. nasal not licensed for NE but much evidence from this area)No treatment

Other treatment (alarm, desmo combined with anticolinergic-oxibutinin, alarm combined with desmopressin, imipromine

Placebo
Reduction/change in number of wet nights

Dry for 14 consecutive nights

Dry for 6 consecutive months (continuing success)

Dry for 2 consecutive years?

Adverse events (fluid retention, constipation)

Psychological effects (self-esteem, self-concept, PinQ)

Quality of life measure

Drop-outs
What is the clinical and cost effectiveness of desmopressin (nasal, tablets and melts) for children and young people under 19 years old who have nocturnal enuresis (bedwetting)?

(High versus Low Dosages)

Evidence Review
Additional Searches-Non-RCT studies (CCT, cohort level)Children and young people under 19 years old who have nocturnal enuresis (bedwetting)
Sub groups to include patients with:

Day time wetting, urinary urgency and frequency (polissymptomatic)

No day time symptoms (monossymptomatic NE)

Nocturnal Poliuria-large amounts of dilute urine in the first 1/3 of the night.

Young (under 7 years)

Children with sickle cell disease

Special needs (learning disabilities, emotional and behavioural e.g. ADHD)

Secondary onset

Severe wetting (6–7 nights a week)

Family history

Previously successful with alarm and with subsequent relapse
Desmopressin Nasal, tablets and melts (N.B. nasal not licensed for NE but much evidence from this area)No treatment

Other treatment (alarm, desmo combined with anticolinergic-oxibutinin, alarm combined with desmopressin, imipromine

Placebo
Reduction/change in number of wet nights

Dry for 14 consecutive nights

Dry for 6 consecutive months (continuing success)

Dry for 2 consecutive years?

Adverse events (fluid retention, constipation)

Psychological effects (self-esteem, self-concept, PinQ)

Quality of life measure

Drop-outs
What is the clinical and cost effectiveness of tricyclic drugs for children and young people under 19 years old who have nocturnal enuresis(bedwetting)?
Evidence Review
RCT for general NE (bedwetting) population

Non-RCT studies (CCT, cohort level) for subgroup data
Children and young people under 19 years old who have nocturnal enuresis (bedwetting)
Sub groups to include patients with:

Day time wetting, urinary urgency and frequency (polissymptomatic)

No day time symptoms (monossymptomatic NE)

Nocturnal Poliuria-large amounts of dilute urine in the first 1/3 of the night.

Young (under 7 years)

Children with sickle cell disease

Special needs (learning disabilities, emotional and behavioural e.g. ADHD)

Secondary onset

Severe wetting (6–7 nights a week)

Family history

Previously successful with alarm and with subsequent relapse
Tricyclic drugs – Imipramine, amitriptyline, nortriptaline.No treatment

Other treatment

Placebo
Reduction/change in number of wet nights

Dry for 14 consecutive nights

Dry for 6 consecutive months (continuing success)

Dry for 2 consecutive years?

Adverse events (fluid retention, constipation)

Psychological effects (self-esteem, self-concept, PinQ)

Quality of life measure

Drop-outs
What is the clinical and cost effectiveness of anticholinergic drugs for children and young people under 19 years old who have nocturnal enuresis (bedwetting)?

Evidence Review
RCT for general NE (bedwetting) population

Non-RCT studies (CCT, cohort level) for subgroup data
Children and young people under 19 years old who have nocturnal enuresis (bedwetting)
Sub groups to include patients with:

Day time wetting, urinary urgency and frequency (polissymptomatic)

No day time symptoms (monossymptomatic NE)

Nocturnal Poliuria-large amounts of dilute urine in the first 1/3 of the night.

Young (under 7 years)

Children with sickle cell disease

Special needs (learning disabilities, emotional and behavioural e.g. ADHD)

Secondary onset

Severe wetting (6–7 nights a week)

Family history

Previously successful with alarm and with subsequent relapse
Oxybutinin (licensed) Long-acting Tolterodine (not licensed) is in the BNF for childrenNo treatment

Other treatment

Placebo

Combination
Reduction/change in number of wet nights

Dry for 14 consecutive nights

Dry for 6 consecutive months (continuing success)

Dry for 2 consecutive years?

Adverse events (fluid retention, constipation)

Psychological effects (self-esteem, self-concept, PinQ)

Quality of life measure

Drop-outs
What is the clinical and cost effectiveness of dose escalation in oxybutinin for children and young people under 19 years old who have nocturnal enuresis (bedwetting)

Evidence Review
Non-RCT studies (CCT, cohort level) for subgroup dataChildren and young people under 19 years old who have nocturnal enuresis (bedwetting)
Sub groups to include patients with:

Day time wetting, urinary urgency and frequency (polissymptomatic)

No day time symptoms (monossymptomatic NE)

Nocturnal Poliuria-large amounts of dilute urine in the first 1/3 of the night.

Young (under 7 years)

Children with sickle cell disease

Special needs (learning disabilities, emotional and behavioural e.g. ADHD)

Secondary onset

Severe wetting (6–7 nights a week)

Family history

Previously successful with alarm and with subsequent relapse
Oxybutinin (licensed) is in the BNF for childrenNo treatment

Other treatment

Placebo

Combination
Reduction/change in number of wet nights

Dry for 14 consecutive nights

Dry for 6 consecutive months (continuing success)

Dry for 2 consecutive years?

Adverse events (fluid retention, constipation)

Psychological effects (self-esteem, self-concept, PinQ)

Quality of life measure

Drop-outs
What is the clinical and cost effectiveness of dose escalation in imipramine for children and young people under 19 years old who have nocturnal enuresis (bedwetting)

Evidence Review
Non-RCT studies (CCT, cohort level) for subgroup dataChildren and young people under 19 years old who have nocturnal enuresis (bedwetting)
Sub groups to include patients with:

Day time wetting, urinary urgency and frequency (polissymptomatic)

No day time symptoms (monossymptomatic NE)

Nocturnal Poliuria- large amounts of dilute urine in the first 1/3 of the night.

Young (under 7 years)

Children with sickle cell disease

Special needs (learning disabilities, emotional and behavioural e.g. ADHD)

Secondary onset

Severe wetting (6–7 nights a week)

Family history

Previously successful with alarm and with subsequent relapse
ImipramineNo treatment

Other treatment

Placebo

Combination
Reduction/change in number of wet nights

Dry for 14 consecutive nights

Dry for 6 consecutive months (continuing success)

Dry for 2 consecutive years?

Adverse events (fluid retention, constipation)

Psychological effects (self-esteem, self- concept, PinQ)

Quality of life measure

Drop-outs
Education/psychological interventions
What is the clinical and cost effectiveness of educational/information interventions for children and young people under 19 years old who have nocturnal enuresis (bedwetting)?

Evidence Review

What are the educational needs of children and young people under 19 years old who have nocturnal enuresis (bedwetting)?

No evidence identified.
RCT for general NE (bedwetting) population

Non-RCT studies (CCT, cohort level) for subgroup data
Children and young people under 19 years old who have nocturnal enuresis (bedwetting)

Sub groups to include patients with:

Special needs (learning disabilities, emotional and ADHD)
What is the clinical and cost effectiveness of psychological interventions for children and young people under 19 years old who have nocturnal enuresis (bedwetting)?

Evidence Review
RCT for general NE (bedwetting) population

Non-RCT studies (CCT, cohort level) for subgroup data
Children and young people under 19 years old who have nocturnal enuresis (bedwetting)
Sub groups to include patients with:

Day time wetting, urinary urgency and frequency (polissymptomatic)

No day time symptoms (monossymptomatic NE)

Nocturnal Poliuria- large amounts of dilute urine in the first 1/3 of the night.

Young (under 7 years)

Special needs (learning disabilities, emotional and behavioural e.g. ADHD)

Secondary onset

Severe wetting (6–7 nights a week)

Family history

Previously successful with alarm and with subsequent relapse
Alternative interventions
What is the clinical and cost effectiveness of alternative interventions for children and young people under 19 years old who have nocturnal enuresis (bedwetting)?

Evidence Review
RCT for general NE (bedwetting) population

Non-RCT studies (CCT, cohort level) for subgroup data
Children and young people under 19 years old who have nocturnal enuresis (bedwetting)
Sub groups to include patients with:

Day time wetting, urinary urgency and frequency (polissymptomatic)

No day time symptoms (monosymptomatic NE)

Nocturnal Poliuria- large amounts of dilute urine in the first 1/3 of the night.

Young (under 7 years)

Special needs (learning disabilities, emotional and behavioural e.g. ADHD)

Secondary onset

Severe wetting (6–7 nights a week)

Family history

Previously successful with alarm and with subsequent relapse
Acupuncture

Hypnotherapy

Chiropractic

Homeopathy

Cranial osteopathy

Reflexology
No treatment

Other treatment

Placebo/sham acupuncture
Reduction/change in number of wet nights

Dry for 14 consecutive nights

Dry for 6 consecutive months (continuing success)

Dry for 2 consecutive years?

Adverse events

Psychological effects (self-esteem, self- concept, PinQ)

Quality of life measure
Drop-outs
What is the clinical and cost effectiveness of the treatment for children and young people aged under 19 years of age who have nocturnal enuresis (bedwetting) and who do not respond to initial treatment with desmopressin and/or enuresis alarms)?

Evidence Review
RCT for general NE (bedwetting) population

Non-RCT studies (CCT, cohort level) for subgroup data.
Children and young people under 19 years old who have nocturnal enuresis (bedwetting)
Sub groups to include patients with:

Day time symptoms

Young (under 7 years)

Special needs (learning disabilities, emotional and ADHD)

Severe wetting (6–7 nights a week)

Previously successful and with subsequent relapse
Drug, alarm or any other intervention listed under the KCQsNo treatment

Other treatment
Continued success

Response/partial response

Psychological effects(self-esteem, self-concept, PinQ)

Quality of life measure

Drop out

Nocturnal enuresis (bedwetting) search strategies

The strategies were developed for use on the OVID interface and Search 2 via NLH. The following databases were searched: Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment Database (HTA), MEDLINE, EMBASE, CENTRAL, CINAHL and PsycINFO.

The Economic literature was searched using an economic and quality of life filter developed by ScHARR for Medline and EMBASE. The following were searched: NHS Economic Evaluations Database (NHSEED), MEDLINE, and EMBASE.

Searches were conducted for systematic reviews and randomised controlled trials using search filters developed by the Centre for Reviews and Dissemination, SIGN and Cochrane Collaboration. Additional searches were undertaken for studies of other designs.

Copies of all the search strategies are available on request from the National Clinical Guidelines Centre.

CENTRAL database via Cochrane Library Issue 4 2008
Searched 14/10/08 update 13/11/09

#1.

MeSH descriptor Nocturnal Enuresis explode all trees

#2.

(betwett* or (bed near/2 wett*)):ti,ab

#3.

(nocturna* near/2 (enuresis or enuretic* or incontinence)):ti,ab

#4.

(night* near/2 (enuresis or enuretic* or incontinence)):ti,ab

#5.

(sleep near/2 (enuresis or enuretic* or incontinence)):ti,ab

#6.

(enuresis near/1 nocturna):ti,ab

#7.

(child* near/1 enuresis):ti,ab

#8.

MeSH descriptor Enuresis, this term only

#9.

MeSH descriptor Pediatrics, this term only

#10.

MeSH descriptor Adolescent, this term only

#11.

(child* or pediatric* or paediatric* or boy* or girl* or juvenile* or teen* or adolescen* or youth*):ti,ab

#12.

child*:kw

#13.

(#1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7)

#14.

(#9 OR #10 OR #11 OR #12)

#15.

(#8 AND #14)

#16.

(#13 OR #15)

DARE database 1995–2008 & HTA Database 1995–2008
Via CRD Databases http://www.crd.york.ac.uk/CRDWeb/
Searched 13/10/08, update 13/11/09

# 1.

enuresis

# 2.

MeSH Enuresis EXPLODE

# 3.

bedwet*

# 4.

bed NEAR wet*

# 5.

night* NEAR incontinence

# 6.

sleep* NEAR incontinence

# 7.

enuretic*

# 8.

nocturnal NEAR incontinence

# 9.

#1 or #2 or #3 or #4 or #5 or #6 or #7 or #8

Database: Ovid MEDLINE(R) <1950 to present
Via Ovid SP searched 13/10/08, 26/02/09
Update search: 15/12/09

1.1.

Search Strategy

  1. (bedwett$ or (bed adj2 wett$)).ti,ab.
  2. (enuresis adj nocturna).ti,ab.
  3. (nocturna$ adj2 (enuresis or enuretic$ or incontinence)).ti,ab.
  4. (night$ adj2 (enuresis or enuretic$ or incontinence)).ti,ab.
  5. (sleep adj2 (enuresis or enuretic$ or incontinence)).ti,ab.
  6. (child$ adj enuresis).ti,ab.
  7. or/1–7
  8. exp child/
  9. pediatrics/
  10. adolescent/
  11. (child$ or pediatric$ or paediatric$ or boy$ or girl$ or juvenile$ or teen$ or adolescen$ or youth$).ti,ab.
  12. or/10–13
  13. 9 and 14
  14. 8 or 15

Database: EMBASE <1980 to present
Searched 13/10/08 and 26/02/09
update search: 15/12/09
Search Strategy

  1. (bed wett$ or (bed adj2 wett$)).ti,ab.
  2. enuresis nocturna.ti,ab.
  3. (nocturna$ adj2 (enuresis or enuretic$ or incontinence)).ti,ab.
  4. (night$ adj2 (enuresis or enureetic$ or incontinence)).ti,ab.
  5. (sleep adj2 (enuresis or enuretic$ or incontinence)).ti,ab.
  6. (child$ adj enuresis).ti,ab.
  7. or/1–7
  8. Child/
  9. pediatrics/
  10. Adolescent/
  11. juvenile/
  12. (child$ or pediatric$ or paediatric$ or boy$ or girl$ or juvenile$ or teen$ or adolescen$ or youth$).ti,ab.
  13. or/10–14
  14. 9 and 15
  15. 8 or 16

Cinahl 1982-present via NLH Search 2
Searched 14/10/08, 26/2/09
Update search 13/11/09

1.2.

Search History

2.

CINAHL; (enuresis ADJ nocturna).ti,ab;.

6.

CINAHL; (child* ADJ enuresis).ti,ab;

7.

CINAHL; (nocturna adj2 enuresis).ti,ab;

8.

CINAHL; (nocturna* adj2 enuresis).ti,ab;.

9.

CINAHL; (nocturna* adj2 enuretic*).ti,ab;

10.

CINAHL; (nocturna* adj2 incontinence*).ti,ab;

11.

CINAHL; (sleep adj2 enuresis).ti,ab;

12.

CINAHL; (sleep adj2 enuret*).ti,ab;

13.

CINAHL; (sleep adj2 incontinence*).ti,ab;

14.

CINAHL; (night* adj2 enuresis).ti,ab;

15.

CINAHL; (night* adj2 enuret*).ti,ab;

16.

CINAHL; (night* adj2 incontinence).ti,ab;

17.

CINAHL; (bedwett*).ti,ab;

19.

CINAHL; (bed adj1 wett*).ti,ab;.

20.

CINAHL; 2 OR 6 OR 7 OR 8 OR 9 OR 10 OR 11 OR 12 OR 13 OR 14 OR 15 OR 16 OR 17 OR 19;

21.

CINAHL; ENURESIS/;.

22.

CINAHL; exp CHILD/;

23.

CINAHL; PEDIATRICS/;

24.

CINAHL; ADOLESCENCE/;

25.

CINAHL; (child* OR pediatric* OR paediatric*).ti,ab;

26.

CINAHL; (boy* OR girl* OR juvenile*).ti,ab;

27.

CINAHL; (adolescen* OR teen* OR youth*).ti,ab;

28.

CINAHL; 22 OR 23 OR 24 OR 25 OR 26 OR 27;

29.

CINAHL; 21 AND 28;

30.

CINAHL; 20 OR 29;

PsycINFO 1802-present via NLH Search 2
Searched 14/10/08, 26/02/09
Update search 13/11/09
Search History

1.

PsycINFO, (bedwett*).ti,ab;

3.

PsycINFO, (bed adj2 wett*).ti,ab;

4.

PsycINFO, (enuresis ADJ nocturna).ti,ab;

5.

PsycINFO, (nocturna* adj2 enuresis).ti,ab;

6.

PsycINFO, (nocturna* adj2 enuret*).ti,ab;

7.

PsycINFO, (nocturna* adj2 incontinence).ti,ab;

8.

PsycINFO, (night* adj2 incontinence).ti,ab;.

9.

PsycINFO, (night* adj2 enuret*).ti,ab;

10.

PsycINFO (night* adj2 enuresis).ti,ab;

11.

PsycINFO, (sleep adj2 enuresis).ti,ab;.

12.

PsycINFO, (sleep adj2 enuret*).ti,ab;

13.

PsycINFO, (sleep adj2 incontinence).ti,ab;

14.

PsycINFO, (child* adj1 enuresis).ti,ab;

15.

PsycINFO, 1 OR 3 OR 4 OR 5 OR 6 OR 7 OR 8 OR 9 OR 10 OR 11 OR 12 OR 13 OR 14;

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Cover of Nocturnal Enuresis
Nocturnal Enuresis: The Management of Bedwetting in Children and Young People.
NICE Clinical Guidelines, No. 111.
National Clinical Guideline Centre (UK).

NICE (National Institute for Health and Care Excellence)

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