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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 HGRADE profile tables

1.5. Dry bed training for the management of bedwetting

Table 1.5-1. Dry bed training without an alarm compared to no treatment - Clinical study characteristics

Table 1.5-2. Dry bed training without an alarm compared to dry bed training with an alarm - Clinical study characteristics

Table 1.5-3. Dry bed training without an alarm compared to dry bed training with an alarm with therapist at hospital-Clinical study characteristics

Table 1.5-4. Dry bed training without an alarm compared to dry bed training with an alarm with parent as therapist - Clinical study characteristics

Table 1.5-5. Dry bed training without an alarm compared to an alarm - Clinical study characteristics

Table 1.5-6. Dry bed training with an alarm compared to no treatment - Clinical study characteristics

Table 1.5-7. Dry bed training with an alarm with therapist at hospital compared to no treatment - Clinical study characteristics

Table 1.5-8. Dry bed training with an alarm with parent as therapist compared to no treatment - Clinical study characteristics

Table 1.5-9. Dry bed training with an alarm with therapist at home compared to dry bed training with an alarm with therapist at hospital - Clinical study characteristics

Table 1.5-10. Dry bed training with an alarm with therapist at home compared to dry bed training with an alarm with parents as therapist - Clinical study characteristics

Table 1.5-11. Dry bed training with an alarm with therapist at hospital compared to dry bed training with an alarm with parents as therapist - Clinical study characteristics

Table 1.5-12. Dry bed training with an alarm compared to an alarm - Clinical study characteristics

Table 1.5-13. Dry bed training with an alarm with parents as therapist compared to an alarm - Clinical study characteristics

Table 1.5-14. Dry bed training with an alarm compared to stop start training - Clinical study characteristics

Table 1.5-15. Dry bed training with an alarm compared to star charts - Clinical study characteristics

Table 1.5-16. Dry bed training without an alarm at hospital with parent and child compared to no treatment for children with bedwetting - Clinical study characteristics

Table 1.5-17. Dry bed training without an alarm at home with parent and child compared to no treatment for children with bedwetting - Clinical study characteristics

Table 1.5-18. Dry bed training without an alarm at hospital with parent compared to no treatment for children with bedwetting - Clinical study characteristics

Table 1.5-19. Dry bed training without an alarm at hospital with parent and child compared to dry bed training without an alarm at home with parent and child for children with bedwetting - Clinical study characteristics

Table 1.5-20. Dry bed training without an alarm at hospital with parent and child compared to dry bed training without an alarm at hospital with parent for children with bedwetting - Clinical study characteristics

Table 1.5-21. Dry bed training without an alarm at home with parent and child compared to dry bed training without an alarm at hospital with parent and child for children with bedwetting - Clinical study characteristics

Table 1.5-22. Dry bed training with an alarm compared to no treatment for children with bedwetting - Clinical study characteristics

Table 1.5-23. Dry bed training with an alarm compared to an alarm for children with bedwetting - Clinical study characteristics

1.6. Enuresis Alarms in the management of bedwetting

Table 1.5-24. Enuresis alarm compared to no treatment - Clinical study characteristics

Table 1.5-25. Unsupervised enuresis alarm compared to supervised enuresis alarm - Clinical study characteristics

Table 1.5-26. Enuresis alarm compared to imipramine - Clinical study characteristics

Table 1.5-27. Enuresis alarm compared to amitriptyline - Clinical study characteristics

Table 1.5-28. Enuresis alarm compared to enuresis alarm with desmopressin - Clinical study characteristics

Table 1.5-29. Enuresis alarm and placebo compared to enuresis alarm and desmopressin - Clinical study characteristics

Table 1-5-30. Enuresis alarm compared to enuresis alarm and imipramine - Clinical study characteristics

Table 1.5-31. Enuresis alarm compared to dry bed training - Clinical study characteristics

Table 1.5-32. Enuresis alarm compared to enuresis alarm and retention control training - Clinical study characteristics

Table 1.5-33. Enuresis alarm compared to enuresis alarm and star charts for correct behaviour - Clinical study characteristics

Table 1.5-34. Enuresis alarm compared to enuresis alarm and star charts for dry night - Clinical study characteristics

Table 1.5-35. Enuresis alarm and star chart for correct behaviour compared to enuresis alarm and star charts for dry night - Clinical study characteristics

Table 1.5-36. Enuresis alarm compared to no treatment for children with bedwetting - Clinical study characteristics

Table 1.5-37. Pad and bell enuresis alarm compared to body worn enuresis alarm - Clinical study characteristics

Table 1.5-38. Enuresis alarm compared to desmopressin - Clinical study characteristics

Table 1.5-39. Enuresis alarm compared to imipramine for children with bedwetting - Clinical study characteristics

Table 1.5-40. Enuresis alarm compared to enuresis alarm with desmopressin for children with bedwetting - Clinical study characteristics

Table 1.5-41. Enuresis alarm compared to dry bed training for children with bedwetting - Clinical study characteristics

Table 1.5-42. Enuresis alarm compared to enuresis alarm and retention control training for children with bedwetting - Clinical study characteristics

Table 1.5-43. Enuresis alarm compared to desmopressin for children with monosymptomatic nocturnal enuresis - Clinical study characteristics

Table 1.5-44. Enuresis alarm compared to enuresis alarm with desmopressin for children with monosymptomatic nocturnal enuresis - Clinical study characteristics

Table 1.5-45. Enuresis alarm compared to no treatment for children with severe wetting - Clinical study characteristics

Table 1.5-46. Enuresis alarm compared to enuresis alarm and desmopressin for children with severe wetting - Clinical study characteristics

Table 1.5-47. Enuresis alarm compared to enuresis alarm and desmopressin for children with family and behavioural problems - Clinical study characteristics

1.7. Desmopressin and the management of bedwetting

Table 1.7-1. 20 micro grams intranasal desmopressin compared to placebo - Clinical study characteristics

Table 1.7-2. Intranasal desmopressin compared to amitriptyline - Clinical study characteristics

Table 1.7-3. Intranasal desmopressin compared to imipramine - Clinical study characteristics

Table 1.7-4. Tablet desmopressin compared to imipramine - Clinical study characteristics

Table 1.7-5. Tablet desmopressin compared to imipramine for children with night and day wetting - Clinical study characteristics

Table 1.7-6. Intranasal desmopressin compared to intranasal desmopressin and amitriptyline - Clinical study characteristics

Table 1.7-7. Tablet desmopressin compared to tablet desmopressin and oxybutynin - Clinical study characteristics

Table 1.7-8. Tablet desmopressin compared to tablet desmopressin and oxybutynin for children with night and day wetting - Clinical study characteristics

Table 1.7-9. 0.2mg tablet desmopressin compared to placebo - Clinical study characteristics

Table 1.7-10. 0.4 mg tablet desmopressin compared to placebo - Clinical study characteristics

Table 1.7-11. 0.6 mg tablet desmopressin compared to placebo - Clinical study characteristics

Table 1.7-12. 0.2 mg tablet desmopressin compared to 0.4 mg tablet desmopressin - Clinical study characteristics

Table 1.7-13. 0.2 mg tablet desmopressin compared to 0.6 mg tablet desmopressin - Clinical study characteristics

Table 1.7-14. 0.4 mg tablet desmopressin compared to 0.6 mg tablet desmopressin - Clinical study characteristics

Table 1.7-15. Tablet desmopressin compared to melt desmopressin - Clinical study characteristics

Table 1.7-16. Intranasal desmopressin compared to enuresis alarm for children with bedwetting - Clinical study characteristics

Table 1.7-17. Tablet desmopressin compared to enuresis alarm - Clinical study characteristics

Table 1.7-18. All desmopressin compared to enuresis alarm - Clinical study characteristics

Table 1.7-19. Tablet desmopressin compared to imipramine for children with bedwetting - Clinical study characteristics

Table 1.7-20. Tablet desmopressin compared to tablet desmopressin and enuresis alarm for children with bedwetting - Clinical study characteristics

Table 1.7-21. Tablet desmopressin compared to tablet desmopressin and oxybutynin for children with bedwetting - Clinical study characteristics

Table 1.7-22. 20 micro grams intranasal desmopressin compared to placebo for children with monosymptomatic nocturnal enuresis - Clinical study characteristics

Table 1.7-23. 40 micro grams intranasal desmopressin compared to placebo for children with monosymptomatic nocturnal enuresis - Clinical study characteristics

Table 1.7-24. 0.4 mg tablet desmopressin compared to placebo for children with monosymptomatic nocturnal enuresis - Clinical study characteristics

Table 1.7-25. Intranasal desmopressin compared to enuresis alarm for children with monosymptomatic nocturnal enuresis - Clinical study characteristics

Table 1.7-26. Desmopressin compared to enuresis alarm - Clinical study characteristics

Table 1.7-27. All desmopressin compared to enuresis alarm for children with monosymptomatic nocturnal enuresis - Clinical study characteristics

Table 1.7-28. 10 micro grams intranasal desmopressin compared to placebo - Clinical study characteristics

Table 1.7-29. 40 micro grams intranasal desmopressin compared to placebo for young children - Clinical study characteristics

Table 1.7-30. 10 micro grams intranasal desmopressin compared to 40 micro grams intranasal desmopressin - Clinical study characteristics

Table 1.7-31. Side effects of tablet desmopressin compared to placebo - Clinical study characteristics

Table 1.7.32. Side effects of tablet desmopressin compared to melt desmopressin - Clinical study characteristics

1.8. Tricyclic medication and the management of bedwetting

Table 1.8-1. Imipramine compared to placebo - Clinical study characteristics

Table 1.8-2. Low dose imipramine compared to placebo - Clinical study characteristics

Table 1.8-3. Low dose imipramine compared to high dose imipramine - Clinical study characteristics

Table 1.8-4. Imipramine compared to desmopressin - Clinical study characteristics

Table 1.8-5. Imipramine compared to desmopressin - Clinical study characteristics

Table 1.8-6. Imipramine compared to alarm - Clinical study characteristics

Table 1.8-7. Imipramine compared to imipramine and alarm - Clinical study characteristics

Table 1.8-8. Imipramine compared to desmopressin and oxybutynin - Clinical study characteristics

Table 1.8-9. Imipramine compared to desmopressin and oxybutynin - Clinical study characteristics

Table 1.8-10. Amitriptyline compared to placebo - Clinical study characteristics

Table 1.8-11. Amitriptyline compared to desmopressin - Clinical study characteristics

Table 1.8-12. Amitriptyline compared to alarm - Clinical study characteristics

Table 1.8-13. Amitriptyline compared to amitriptyline and desmopressin - Clinical study characteristics

Table 1.8-14. Nortriptyline compared to placebo - Clinical study characteristics

Table 1.8-15. Imipramine compared to placebo for children with bedwetting - Clinical study characteristics

Table 1.8-16. Imipramine compared to desmopressin - Clinical study characteristics

Table 1.8-17. Imipramine compared to oxybutynin - Clinical study characteristics

Table 1.8-18. Imipramine compared to alarm - Clinical study characteristics

Table 1.8-19. Imipramine compared to imipramine and oxybutynin - Clinical study characteristics

Table 1.8-20. Imipramine compared to desmopressin and oxybutynin - Clinical study characteristics

Table 1.8-21. Imipramine compared to placebo for children with severe wetting - Clinical study characteristics

Table 1.8-22. Imipramine and placebo compared to placebo - Clinical study characteristics

Table 1.8-23. Imipramine and placebo compared to nortriptyline and placebo - Clinical study characteristics

Table 1.8-24. Nortriptyline and placebo compared to placebo - Clinical study characteristics

Table 1.8-25. Imipramine compared to placebo - Clinical study characteristics

Table 1.8-26. Low dose imipramine compared to placebo - Clinical study characteristics

Table 1.8-27. Low dose imipramine compared to high dose imipramine - Clinical study characteristics

Table 1.8-28. Imipramine compared to desmopressin - Clinical study characteristics

Table 1.8-29. Amitriptyline compared to placebo - Clinical study characteristics

Table 1.8-30. Nortiptyline compared to placebo - Clinical study characteristics

Table 1.8-31. Imipramine compared to placebo - Clinical study characteristics

Table 1.8-32. Imipramine compared to oxybutynin - Clinical study characteristics

Table 1.8-33. Imipramine compared to imipramine and oxybutynin - Clinical study characteristics

1.11. Treatment for children who do not respond to initial treatment with desmopressin and/or enuresis alarms for the management of bedwetting

Table 1.11-1. Enuresis alarm compared to DBT for children resistant to enuresis alarms - Clinical study characteristics

Table 1.11-2. Desmopressin compared to placebo for children resistant to enuresis alarms - Clinical study characteristics

Table 1.11-3. Enuresis alarm and placebo compared to enuresis alarm and desmopressin for children resistant to enuresis alarm or desmopressin - Clinical study characteristics

Table 1.11-4. Desmopressin compared to placebo for children resistant to tricyclics - Clinical study characteristics

Table 1.11-5. Desmopressin compared to placebo for children with severe wetting resistant to enuresis alarms - Clinical study characteristics

Table 1.11-6. Desmopressin tablets compared to placebo for children with bedwetting resistant to enuresis alarms or desmopressin - Clinical study characteristics

Table 1.11-7. Desmopressin spray compared to placebo for children with bedwetting resistant to enuresis alarms or desmopressin - Clinical study characteristics

Table 1.11-8. Tablet desmopressin compared to intranasal desmopressin for children with bedwetting resistant to enuresis alarms or desmopressin - Clinical study characteristics

Table 1.11-9. Imipramine compared to placebo for children with bedwetting resistant to enuresis alarms and desmopressin - Clinical study characteristics

Table 1.11-10. Imipramine compared to tolterodine for children with bedwetting resistant to enuresis alarms and desmopressin - Clinical study characteristics

Table 1.11-11. Tolterodine compared to placebo for children with bedwetting resistant to enuresis alarms and desmopressin - Clinical study characteristics

Table 1.11-12. Desmopressin compared to placebo for children treatment resistant to imipramine therapy - Clinical study characteristics

Table 1.11-13. Desmopressin and placebo compared to desmopressin and tolterodine for monosymptomatic children resistant to desmopressin - Clinical study characteristics

Table 1.11-14. Enuresis alarm and desmopressin compared to enuresis alarm and placebo - Clinical study characteristics

Table 1.11-15. Desmopressin compared to placebo - Clinical study characteristics

Table 1.11-16. Imipramine compared to tolterodine - Clinical study characteristics

Table 1.11-17. Tolterodine compared to imipramine - Clinical study characteristics

Children resistant to TRICYCLIC therapy

Desmopressin compared to placebo for children resistant to imipramine therapy

Two randomised controlled trials, Aladjem (1982) (Aladjem et al. 137-40) and Tuvemo (1978) (Tuvemo 753-55) compared desmopressin to placebo in children who had not responded to tricyclics. Aladjem (1982) (Aladjem et al. 137-40) gave children 10 μg intranasal desmopressin and Tuvemo (1978) (Tuvemo 753-55) gave children 20 μg micrograms intranasal desmopressin.

Table 1.11-18. Desmopressin compared to placebo for children resistant to tricyclics - Clinical summary of findings

Oxybutynin for children who had previously failed to respond to imipramine

One observational study Kosar (1999) (Kosar, Arikan, and Dincel 115-18) considered oxybutynin treatment for children who had not responded to treatment with imipramine.. The study outcome was the mean number of wet nights per week at the end of treatment. Children had an age range of 6 to 18 years and had 3 months of treatment. All patients had failed to respond to imipramine (25 mg for children aged 6 to 8 years and 50 mg from children aged over 8 years). Children were given 10 mg daily oxybutynin for one month, if they did not respond they were given 15 mg daily oxybutynin for one month, they did not respond again their dose was increased to 20 mg daily oxybutynin.

Children resistant to IMIPRAMINE

Desmopressin compared to no treatment for children with bedwetting for children resistant to imipramine therapy

One randomised controlled trial Terho (1984) (Terho and Kekomaki 925-27) compared 20 μg intranasal desmopressin to no treatment for children resistant to imipramine.

Table 1.11-19. Desmopressin compared to placebo for children treatment resistant to imipramine therapy - Clinical summary of findings

Copyright © 2010, National Clinical Guideline Centre.

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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).

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