This study was approved by Ethics Committee in our Hospital. Enuresis has a high prevalence among children with high impact in their quality of life and in the families. We have compared prospectively different approaches for this condition analyzing efficacy, safety and relapse.

We have studied 93 consecutive children (55 males and 38 females) in our service with a diagnosis of nocturnal monossymptomatic enuresis. All patients were submitted to behavior therapy during 3three months: timely voiding, fluids restriction, improvement in bowel function. After this period all patients remained with behavior therapy. The patients who remained with enuresis were randomized for observation (behavior only), bedwetting alarm, imipramine (maximum doses= 25 mg/Day) and desmopressin (maximum doses= 0,4 mg/Day).

Table 1 show demography and improvement in enuresis following the four treatment modalities. Alarm was superior to observation, DDAVP and imipramine for both (p= 0,015; 0,001 and 0,012 respectively). After 6 months 65 % of children treated with alarms had no enuresis anymore. No significant side effects were observed with any form of treatment

Bedwetting alarms are a safe and effective treatment for monossymptomatic enuresis. When compared with other treatment options they result in higher levels of cure and lower levels of relapse.

Bedwetting alarms should b the first choice in the treatment of monossymptomatic enuresis. Other options may remain a second line of treatment for children who do not accept or not respond to alarms