Primary versus Secondary Enuresis

Abstract

Thirty-one primary and 18 secondary nocturnal enuretic children were recruited for assessment and treatment with urine-alarm conditioning. Treatment of 12 weeks' duration was accepted and completed in 20 primary and 11 secondary cases. Measures of bedwetting, anxiety and behavioral disturbance were obtained at pre- and posttteatment assessments. Bedwetting was also assessed at a 6-month follow-up. In comparison to secondary enuretics, primary enuretics had a significantly higher likelihood of reaching the initial arrest criterion of 14 consecutive dry nights and a significantly greater overall reduction in frequency of wet nights during treatment. For the change from baseline to follow-up, the Type X Occasions interaction just failed to reach significance. The two groups did not differ on pretreatment measures of anxiety and behavioral disturbance nor in pre-post changes on these measures. It was concluded that the primary-secondary distinction has significant prognostic utility in relation to urine-alarm treatment. Reasons for the value of this distinction are discussed in relation to treatment compliance, anxiety and behavioral disturbance.