The voiding alert system: a new application in the treatment of incontinence.

The voiding alarm system was developed to control nocturnal enuresis in children more than 5 years of age. Its acceptance by American clinicians, including pediatricians, has been modest at best. This article describes a new application of the voiding alarm system in different patient populations. The concept is that of notifying care attendants of voiding by individuals who are unaware or unable to communicate. Five case examples are presented involving individuals in a long-term care facility with neurogenic bladder, spina bifida, traumatic spinal cord injury, stress incontinence, and organic brain syndrome. Benefits were documented with respect to accurate measurements of post-void residual volumes, titering of oxybutynin chloride medication to the minimum effective dose, and the elimination of indwelling urinary catheters in the treatment of incontinence causing perineal skin breakdown. Further developments of the voiding alarm system are postulated for use in multiple clinical environments.