Improving the cure rate of alarm treatment for monosymptomatic nocturnal enuresis by increasing bladder capacity--a randomized controlled trial in children.

PURPOSE: We prospectively assessed response and cure rates of alarm treatment, following pretreatment with antimuscarinics and/or holding exercises aimed at increasing maximum volume voided in 149 children with monosymptomatic nocturnal enuresis. MATERIALS AND METHODS: In a prior trial the same 149 children had been randomized into 5 groups to assess interventions for increasing maximum volume voided, namely placebo or antimuscarinics with (groups A and B, respectively) and without (C and D, respectively) holding exercises, and a control group (E) receiving just alarm treatment. Following pretreatment groups A to D received alarm treatment. Full response and cure rates were assessed, as well as the influence on these rates of baseline maximum volume voided, increase in maximum volume voided after pretreatment, gender, age and previous treatment. RESULTS: Neither full response nor cure was influenced significantly by the increase in maximum volume voided achieved in groups A and B with holding exercises. Overall full response ranged from 50% to 73%, and overall cure ranged from 50% to 67%. Possible predictors for full response and cure were prior treatment (p <0.02) and age younger than 8 years (p <0.05). CONCLUSIONS: In monosymptomatic nocturnal enuresis increasing maximum volume voided does not affect response or cure rate of subsequent alarm treatment. Previous treatment and age younger than 8 years are possible predictors for response and cure.