Enuresis: an analysis of various therapeutic approaches

Three hundred enuretic patients from 3 to 14 years of age were treated by various techniques and the effectiveness of these techniques was evaluated. Boys outnumbered girls in the overall group; however, there was no appreciable sex difference in the responses. When the child took an active responsibility for seeking to change his behavior pattern and was supported by reinforcement from his family and physician, the results appeared to be more successful than when the child was a passive participant in the therapy, as with instrumentation-surgery, medications, or conditioning devices. Improvement in these latter groups was frequently more rapid, but the relapse rate higher than in the "responsibility-reinforcement" approach. Although the results from our study could not be considered statistically significant, there is a trend showing that the "responsibility-reinforcement" technique produces more successful longterm results than the therapies employing instrumentation-surgery, medications, or conditioning devices. Of greater import is the fact that the "responsibility-reinforcement" technique is less disruptive than other therapeutic modalities from the physiological as well as the psychological standpoint. For these reasons, when organic causes can be ruled out, we believe that the "responsibility-reinforcement" technique is the optimal initial approach for the treatment of enuresis.