Self-guided Medical Hypnosis Program as FIrst-Line Therapy Improves Dryness in Children With Monosymptomatic Nocturnal Enuresis in a Prospective Single-Center Study
Aaron Bayne, MD.
Oregon Health Sciences University, Portland, OR, USA.
Background: Primary Monosymptomatic Nocturnal Enuresis (PMNE) is usually managed with bed alarm therapy or desmopressin (DDAVP) as first line treatments. We sought to evaluate the effectiveness of medical hypnosis as a first line therapy in children with PMNE. Hypothesis: Self-guided medical hypnosis will improve the number of dry days per month in children with PMNE.
Methods: The study enrolled children in a prospective single center clinical trial consisting of one month diary of dry days prior to hypnosis intervention followed by three consecutive months diary following intervention. The hypnosis intervention was a commercially available product (www.keepingthebeddry.com). Only children with PMNE were included. Children with untreated constipation, history of recent use of DDAVP or recent use of the bed alarm were excluded as well as children with BMI over 85%.
Results: 17 children ages 8-15 years old (11 males) were enrolled and 12 recorded at least one month data after the hypnosis intervention. The median dry days prior to intervention was 8 (0-17) and improved to 13 (2-23) the first month after intervention and 15.5 days (7-28) by the third month post intervention (p=0.0033). Intervention resulted in no complications and all patients who completed the intervention showed an improvement in dry days by the final month post-intervention.
Conclusion: Self-guided medical hypnosis therapy showed significant improvement in dry days comparable to the bed alarm and DDAVP without any side effects and any identifiable risk to patient or family. Finally, the therapy is done entirely by the child without physician or parent intervention thus making it an ideal potential first line therapy for a motivated child with PMNE. 
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