Which statement is true about enuresis management, reflecting the priority described in the material?

Which statement is true about enuresis management, reflecting the priority described in the material?

• A. The alarm is the safest therapy, but the relapse rate is about 10%
• B. Pharmacologic therapy has the lowest relapse rate
• C. Motivational therapy should be used after pharmacologic treatment
• D. Treatment should begin with bladder awareness training

Answer: (A)

Alarm therapy is the preferred starting approach for nocturnal enuresis because it directly trains the child to wake in response to a full bladder, leading to durable improvement with essentially no pharmacologic side effects. It has the strongest evidence base for long‑term success, and the relapse rate after achieving dry nights is relatively low—about 10% in the material—reflecting a lasting behavioral change. Pharmacologic therapy, like desmopressin, can produce a quick improvement but often has higher relapse after stopping and does not teach the child to awaken to fullness, which is why it isn’t the top priority if a safe, lasting solution is available. Motivational strategies and bladder awareness training can support treatment but are not typically used as the sole first‑line therapy; they play a supplementary role rather than replacing alarm therapy.

Alarm therapy is the preferred starting approach for nocturnal enuresis because it directly trains the child to wake in response to a full bladder, leading to durable improvement with essentially no pharmacologic side effects. It has the strongest evidence base for long‑term success, and the relapse rate after achieving dry nights is relatively low—about 10% in the material—reflecting a lasting behavioral change.

Pharmacologic therapy, like desmopressin, can produce a quick improvement but often has higher relapse after stopping and does not teach the child to awaken to fullness, which is why it isn’t the top priority if a safe, lasting solution is available. Motivational strategies and bladder awareness training can support treatment but are not typically used as the sole first‑line therapy; they play a supplementary role rather than replacing alarm therapy.