Long-term efficacy of simple behavioral therapy for daytime wetting in children

Purpose: Behavioral therapy has proved benefit for children with daytime we tting but most studies have used biofeedback techniques and provide no long -term assessment of results. We previously reported similar results using s imple behavioral therapy without biofeedback. We report the long-term effic acy of behavioral therapy for daytime wetting. Materials and Methods: Our program of behavioral therapy included timed voi ding, modification of fluid intake, positive reinforcement techniques and p elvic floor (Kegel) exercises to promote pelvic floor strengthening and rel axation. Questionnaires to assess therapeutic efficacy were mailed to patie nts who had completed therapy more than 1 year previously. Results: A total of 48 patients responded. Mean ages at the time of the ini tial clinic visit and questionnaire were 8.2 and 12.9 years, respectively. Improvement in symptoms was noted in approximately 74% of the cases during the first year following therapy. At a mean of 4.7 years after treatment 59 .4% of the patients had improved daytime urinary control, 51.1% improved da ytime urinary frequency and 45.6% improved daytime urinary urgency. The fre quency of urinary tract infections decreased in 56.4% of the cases. Measure s of psychological well-being were also noted to be improved in a majority of patients. A total of 77.3% of the patients stated that they would recomm end the program to others. Conclusions: Simple behavioral therapy without biofeedback techniques is an effective and durable first line therapy for children with daytime wetting .