An 8-year-old boy has wet his bed almost every night since infancy. He has never had a sustained dry interval, has normal daytime voiding and bowel habits, and urinalysis is normal. Examination is unremarkable. Which intervention offers the best long-term cure rate?

• A Oral desmopressin at bedtime
• B Enuresis alarm ✓
• C Oxybutynin at bedtime
• D Oral imipramine at bedtime

Explanation

This is primary monosymptomatic nocturnal enuresis. The enuresis alarm has the highest permanent cure rate and the lowest relapse rate after discontinuation, though it requires several weeks of motivation. Desmopressin works quickly but relapse is common once it is stopped, so it suits short-term needs such as sleepovers. Imipramine is second line because of cardiotoxicity in overdose, and oxybutynin targets detrusor overactivity with daytime urgency, which this child does not have.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.