The efficacy of the addition of short-term desmopressin to alarm therapy in the treatment of primary nocturnal enuresis.

OBJECTIVE: The purpose was to evaluate the efficacy of the addition of short-term desmopressin to enuretic alarm in patients with primary monosymptomatic nocturnal enuresis (PMNE).

MATERIALS AND METHODS: A total of 58 [corrected] children with PMNE were included in this study. The patients were randomized into two groups. In group 1 (n=30), the patients were given 6 weeks of additional oral desmopressin to 12 weeks of enuretic alarm therapy, as a single dose of 0.2 mg at the first 3 weeks and 0.4 mg at the following 3 weeks. In group 2 (n=28), the patients were given 12 weeks of enuretic alarm therapy alone. According to the number of wet nights after 12 weeks of treatment, the patients were defined as complete responders (dry or more than 75% reduction in wet nights), partial responders (50 to 75% reduction) and non-responders (less than 50% reduction). Relapse was defined as the reappearance of >1 wet night per week for complete responders and >50% increase in pre-treatment wetting frequency for partial responders, and all these patients were called relapsers.

RESULTS: The mean number of wet nights after 3 and 6 weeks treatment was significantly lower in group 1 compared to group 2. However, there was no significant difference between the groups regarding the mean number of wet nights after 12 and 24 weeks of treatment. There was no significant difference between the groups regarding the number of responders, partial responders, non-responders and relapsers. In the group with additional desmopressin therapy given, the number of patients who abandoned therapy was lower than the alarm therapy alone group, but it was not statistically significant.

CONCLUSION: Our data showed that the addition of short-term desmopressin to alarm therapy was more effective only in the period when it was given, and it did not change the response to alarm therapy in the long term.