Abstract

Nocturnal enuresis (NE), commonly known as bedwetting, is one of the most prevalent chronic conditions affecting school-aged children. Though often benign, it imposes significant psychological burden on the child and family. Alarm therapy, a behavioral intervention rooted in classical conditioning, has long been upheld by clinical guidelines as the most effective first-line treatment for monosymptomatic NE (MNE), achieving high initial success and durable cure rates. This comprehensive literature review critically examines the theoretical mechanisms of alarm therapy, evaluates its clinical efficacy compared to pharmacological alternatives, explores critical factors influencing treatment success and failure, and discusses practical implementation challenges, including compliance and relapse management. The evidence overwhelmingly supports the utility of alarm therapy, provided protocols are adhered to, emphasizing the crucial role of parental involvement and the strategic use of ‘overlearning’ to consolidate the conditioned arousal response. Future research should prioritize standardizing treatment protocols and investigating the combined efficacy of behavioral and pharmacological approaches in complex or refractory cases.

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