Comparison Of The Efficacy Between Alarm Therapyand Desmopressin Therapy In The Treatment Of Primary Mono-symptomatic Nocturnalenuresis:a Meta-analysis

Purpose: To assess the efficacy of alarm therapy and desmopressintherapy in the treatment of primary mono-symptomatic nocturnal enuresis（PNE）and to provide advices for the children with Primary nocturnalenuresis.Methods: A comprehensive search for randomized controlled trials(RCTs;) was performed. RCTs comparing the efficacy of alarm therapyversus desmopressin therapy for PNE were selected according to theincluded and excluded criterion. Odds ratio (OR) with95%CI wascalculated for all results. The meta-analysis was performed usingRev-Man5.1.Results:8RCTs were included. There was no significant differenceregarding to the responders between alarm therapy group and DDAVPgroup(MH-OR=0.96,95%CI[0.68,1.36],p=0.83); however, the completeresponders was different(MH-OR=1.57,95%CI[1.10,2.23], p<0.05); therelapse for responders(MH-OR=0.09,95%CI[0.02,0.48], p<0.05) and the relapse for complete responders(MH-OR=0.10,95%CI[0.03,0.38],p<0.05)were also different.The cumulative responders(MH–OR=3.6,95%CI[1.36,9.52],p<0.0),the cumulative complete responders(MH–OR=2.74,95%CI[1.32,5.71],p<0.05) and the compliance(MH–OR=1.73,95%CI[1.15,2.60],p<0.05) were different as well.Conclusions: DDVAP is better than alarm therapy in patients’compliance. Alarm therapy is superior in complete responders、relapse、cumulative responders and cumulative complete responders thandesmopressin therapy. For the children with primary nocturnal enuresiswithout clear pathophysiology types, we reccomend alarm therapy to be thefirst choice. Besides, combined behavior therapy with alarm ordesmopressin therapy may improve the efficacy, but need furtherevidence-based research.