- For children who have daytime urinary incontinence, the literature offers little evidence supporting 1 treatment candidate over others.
Why this matters
- The authors of this Cochrane review say that for now, clinicians should rely on their clinical experience and turn to caregivers as resources.
- Support is key, as this phenomenon can harm a child’s sense of well-being and social engagement.
- Of the 27 randomised controlled trials (RCTs) these authors reviewed, most were small (n values, 16-202).
- Bias risk was high for 19.
- Pooling was difficult because of heterogeneity.
- Interventions reviewed include lifestyle, behavioral, and transcutaneous electrical nerve stimulation (TENS).
- For TENS, some hints at efficacy: risk ratio for achieving continence vs placebo, 4.89 (95% CI, 1.68-14.21), but only 3 studies and only 93 children.
- Pelvic floor muscle training also shows some promise vs urotherapy alone (risk ratio, 2.36; 95% CI, 0.65-8.53), but only 3 studies and only 91 children.
- Other findings are similarly limited.
- Authors: Most of the studies were small, and many were poorly designed and not reported clearly.
- Most evidence is “of very low certainty.”
- Cochrane review of 27 RCTs covering 1803 children.
- Funding: National Institute for Health Research, UK.
- The limitations are those of the included studies.