BACKGROUND: Enuresis persists into adulthood in 0.5-1% of subjects and the negative effects of the condition on self esteem and social wellbeing in these individuals can be assumed to be severe. Very little is known regarding how to treat these individuals. The enuresis alarm is the only potentially curative antienuretic therapy. We wanted to look at the efficacy of the enuresis alarm in adult subjects, compared with children. METHODS: This is part of a larger, multinational study on enuresis alarm therapy using a device that is linked to a smartphone app that records both relevant background data of the subjects, alarm use and wet/dry nights. The app also provides instructions about alarm use in accordance with the ICCS recommendations and can thus be managed independently without seeking help from healthcare. RESULTS: We have collected data from 1905 children and 104 adults. The ages of the adults ranged from 18 to 78 (median 27) years and 36.7% were women. Half (50.0%) of them had secondary enuresis, 36.5% had concomitant daytime incontinence, 32.2% had previously tried alarm therapy and 27.6% had previously tried desmopressin therapy. Their baseline enuresis frequency was 5.1 ± 1.9 nights per week. Comparing background data with the children showed that the adults had a slightly higher proportion of females (p = 0.023), and that they were more prone to have secondary enuresis (p < 0.001) and/or concomitant daytime incontinence (p < 0.001). Only 20/103 managed to use the alarm every night for at least 6 weeks according to the instructions, and of these only one had a complete and one a partial response. Both the chance of adherence and favorable outcome among adherent subjects were significantly lower among adults than children (p < 0.001 in both cases). CONCLUSIONS: Adults have a lower chance of completing enuresis alarm therapy than children and for those who manage to adhere to the instructions the chance of achieving dryness is still very low. Enuresis among adults needs to be pharmacologically treated.
