Frequently Asked Questions (FAQ)

General questions about nocturnal enuresis

What is nocturnal enuresis ?

Commonly referred to as “bedwetting,” nocturnal enuresis is the “unconscious and involuntary emission of urine during sleep.”

How long has nocturnal enuresis been around ?

The first written records on the subject were found on papyrus dating back to 1500 BC. It was not until the 19th century that we began to understand the causes of nocturnal enuresis and suggest treatments. The first bedwetting alarm was invented by Pfaundler in 1907.

What causes nocturnal enuresis ?

Nocturnal enuresis is rarely associated with an underlying illness, and may be caused by one or more of the following factors: delayed development of urine control, small bladder capacity, deep sleep and resulting difficulty waking, and inadequate production of vasopressin, an antidiuretic hormone.

Is bedwetting hereditary ?

Yes, this is a major risk factor for the condition. If one of the parents was a bedwetter, there is a 44% chance that the child will also wet his bed and if both parents wet their beds, the risk increases to 77%. The risk is only 15% without the hereditary element.

Is bedwetting an important health issue ?

Although bedwetting has no serious impact on a child’s physical health, it can have serious repercussions on his or her self-esteem, and also home and social life, often preventing the child from going to camp or enjoying sleep-overs. Also, staying wet all night can cause pelvic area irritation as well as embarrassing odours.

At what age can treatment begin ?

By the age of 5, the bladder and the brain, which control urination, should have reached full maturity. Nocturnal enuresis is generally diagnosed at age 5. As soon as the child is sufficiently motivated (even before age 5), and wants to correct the situation, treatment with an alarm can begin, because the system is easy to use and there are no side effects. Some private insurance plans will reimburse the cost of the treatment as of age 5.

Can we wait until the child stops bedwetting on his own ?

Generally, a child will stop bedwetting on his own, with time. In fact, the rate of spontaneous cure (without intervention) is 15% per year, but there is a higher risk (85%) that the child’s bedwetting condition will persist for many years. Therefore, if the child and/or parents are inconvenienced by the situation, it is a good idea to begin risk-free treatment such as training with an alarm, which will greatly improve quality of life for the whole family. 9. How should we react to our bedwetting child?

What treatments are recommended for bedwetting ?

According to a number of reliable medical sources (Canadian Paediatric Society, Dictionnaire de thérapeutique pédiatrique published by Hôpital Sainte-Justine, etc.), treatment should begin with drug-free conditioning therapy using an alarm. This is the most effective, safe and affordable treatment, with the lowest relapse rate. There are some drugs that can be prescribed, the most common of which is Desmopressin (DDAVP®) but it is expensive, its efficacy is variable, and its effect is a just temporary.

What is the incidence of nocturnal enuresis ?

Nocturnal enuresis is very common in children and usually decreases with age. In general, nocturnal enuresis occurs in more than 15% of 5 year-olds, 8% of 8 year-olds, 3% of 12 year-olds, and 1% of 16 year-olds. Nocturnal enuresis may even continue into adulthood, affecting less than 1% of adults. Bedwetting is twice as common in boys as in girls.

Questions about the services offered by Ledoux Réflexe

How does the follow-up work ?

Parents can transfer data from the daily log to our online follow-up software, for access to personalized graphs. The graphs can be used to encourage the child to keep up the good work and help the parents track the child’s progress.

How can I order an alarm system ?

You can order it through our web site (see the Products section) or by phone at 514-990-7474 or 1-877-326-7474.

How much does it cost to buy the Dry4ever® system ?

The complete system sells for CDN$399. You will find all the details in the Products section. There is no sales tax on our system. Follow-up and analysis of daily logs and graphs are included in the price.

When a complete system is purchased, there is no cost for postage and handling. When purchasing accessories only, such as sensor underwear, the cost of postage is CDN $7.

  • $89.00 payable upon system rental order.
  • + $18.00 weekly.
  • Handling and delivery included.
  • Non-taxable medical equipment.
  • 4 new detector underwear that the customer keeps at the end of the rental period.
  • Vibrator included
  • Daily log, graphics and consultation: for information click “here”

To order a rental system, click here.

The customer can end the rental agreement at any time.

After 20 weeks of paid rental, the system is no longer on rental and becomes property of the customer.

Our treatment is covered by the majority of collective insurance policies in Canada.

Is sales tax included in the price ?

There is no sales tax on medical equipment in Canada. There is therefore no tax (GST or QST) on our Dry4ever® system.

How can you pay for the treatment ?

We accept payment by credit card (Visa or Mastercard), money order, or certified cheque. A receipt will be included with the device.

How will the system be delivered and when can I expect to receive it ?

The alarm system will be shipped via Canada Post Xpresspost service with signature confirmation. If you are not home when the package is delivered, a notice will be left in your mailbox. You will then have to pick up the package at the post office as indicated on the delivery slip.

Once you place your order, delivery time varies according to destination: 1-2 days for Quebec, and 2-6 days for other destinations (Canada, US, Europe).

When a complete system is purchased, there is no cost for postage and handling. When purchasing accessories only, such as sensor underwear, the cost of postage is CDN $7.

Is the treatment covered by private insurance ?

Most private insurance companies in Canada will reimburse all or part of the treatment costs. You must submit your receipts and your medical referral (prescription) with your claim. If you do not know if the treatment is covered, we would be happy to provide you with a quotation and treatment plan for your insurance company, prior to treatment. Some youth centres and charities also cover all or part of the treatment costs.

Questions about treating nocturnal enuresis using the Dry4ever® system

How long does treatment last ?

On average, treatment lasts 7 weeks. For some children, treatment will be shorter and for others, it could be longer. Treatment is generally more demanding in the beginning as the child wets more often, but the situation should gradually improve.

Here are the treatment results for 1,064 patients, according to our company’s 2006 statistics:

• 23.5% achieved success in 30 days or less

• 36.0% achieved success in 31 to 60 days

• 22.0% achieved success in 31 to 90 days

• 18.5% achieved success after 91 days

Click on the following link to view all of our statistics.

What is the success rate for our approach ?

Treatment with Dry4ever®, combined with close personalized follow-up, has a 90% success rate. Coupled with our expertise and motivational approach, the dropout rate is very low. The advice we offer during the treatment decreases the relapse rate.

Can a child continue wearing a diaper or training pants during treatment ?

Yes, our system allows the child to wear a diaper or training pants over our sensor underwear. This will save you from changing the sheets during the night.

Will the child tend to be more tired during treatment with the alarm ?

Generally speaking, no, because in most cases, the next morning the children won’t even remember that the alarm went off. Bedwetters tend to sleep very deeply, even if they do get up once or more during the night, and they wake up refreshed.

My child is a very deep sleeper. Will he wake up when the alarm goes off ?

The alarm has a choice of four different sounds and three volume settings. A vibrator (included) can also be connected to the system (designed to be placed under the mattress or pillow). Even so, some children still manage to sleep through the alarm, but close their urinary sphincter in reaction to the alarm, showing that the conditioning works.

How does the Dry4ever® alarm treatment work ?

The child wears wireless sensor underwear that trigger the Dry4ever® alarm (sound, vibration, light) as soon as the first drops of urine are released. The vibrator is placed under the mattress or pillow. Through repetition (conditioning), the child will learn to wake up on his own to go and urinate or to develop a reflex of contracting his sphincter (muscle that holds urine in the bladder) and keep it closed until morning.

What if the parents are separated and just one parent wants to participate in the treatment ?

The alarm system can be used part-time. The treatment will be just as effective, but may take longer.

What if my child sleeps in the top bunk ?

During treatment, it is possible that your child will wake up to go to the bathroom without letting you know. Since the child may not be completely awake, we recommend that he sleep in the bottom bunk during the treatment period to avoid the risk of falling.

How do I wash the sensor underwear ?

The underwear can be machine washed and dried. The child can wear a diaper or training pants over the underwear because they are not waterproof.

Is parent participation necessary ?

Absolutely. Parent participation is an extremely important if not essential component of the treatment. When the alarm is triggered, most children need help from a parent, although some children are sufficiently independent and can succeed without a parent’s help.

Are there any risks involved in using this type of alarm treatment ?

Using the alarm is very safe and there are no risks or hazards involved. Our Dry4ever® alarm is licensed by Health Canada (no. 72556) and meets the following safety standards: CSA (C22.2 601.1), UL (60601.1) and CENELEC (EN 60601.1). Ledoux Réflexe has also received ISO certification (9001:2000 and 13485:2003) for medical devices.

Are there any risks involved in using this type of alarm treatment ?

Using the alarm is very safe and there are no risks or hazards involved. Our Dry4ever® alarm is licensed by Health Canada (no. 72556) and meets the following safety standards: CSA (C22.2 601.1), UL (60601.1) and CENELEC (EN 60601.1). Ledoux Réflexe has also received ISO certification (9001:2000 and 13485:2003) for medical devices.

Why has Ledoux Réflexe changed its sensor method from a pad on the bed to sensor underwear ?

In 1958, Ledoux Réflexe began by using an alarm connected to a sensor pad on the bed. Since there were some disadvantages associated with this system, we stopped using it and developed sensor underwear. For successful training, the child must learn to recognize the feeling of a full bladder. This conditioning can develop faster if the urine is detected immediately, while the bladder is still full. That is why we began marketing sensor underwear in 1990, which at the time used a wire attached to the pyjamas. Since 2005, we have been offering a new device known as Dry4ever® which was developed and is being manufactured here in Quebec. This system offers the following benefits:

• Sensor underwear: immediate detection regardless of sleeping position

• Vibration: Vibrator placed under the mattress adds a second very effective stimulus

• Choice of alarms sounds: keeps the child from getting used to the sound of the buzzer

What size sensor underwear should I choose for my child ?

If you are hesitating between two sizes, we recommend choosing the larger size. Your child will be more comfortable, and the sensor underwear will last longer if the treatment takes a while or if there is a relapse. In 5% of cases, there may be a relapse even a year later. If the sensor underwear are a little too big, your child could wear a diaper, training pants or a pair of his own underwear over the sensor underwear to keep them in place.

To help you choose the right size for boy’s underwear, please follow this guide:
4 years old
6 years old
Small (7-8 years old)
Medium (10-12 years old)
Large (14-16 years old)

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