Desmopressin improves sleep pattern in patients with nocturnal enuresis (original) (raw)
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Desmopressin in the treatment of severe nocturnal enuresis in adolescents - a 7-year follow-up study
BJU International, 1998
Objectives To evaluate the role of long-term oral desmo-patients remained dry without therapy. Within 2 years of ending treatment, 15 patients were dry, compared pressin (over a 7-year follow-up) in refractory enuretics, particularly in assessing the potential cura-with an expected estimate of six by spontaneous resolution, and after 7 years, 19 patients were cured. tive eCect, and to analyse the results for specific types of patient to obtain clues about possible mechanisms Nocturia occurred in 75% of the enuretic patients but in only 5% of the healthy controls. of cure. Patients and methods The eCect of oral desmopressin Conclusions Active treatment of primary nocturnal enuresis with oral desmopressin has a clinically sig-was investigated in 25 adolescents (aged 11-21 years) with severe monosymptomatic nocturnal enuresis. nificant eCect on the cure rate, which is maintained after ceasing therapy. The cure rate was higher than The long-term study consisted of two 12-week treatment periods, with the eBcacy of the drug assessed as would be expected from spontaneous recovery alone during the first 2 years of the study and there was a the reduction in the number of wet nights per week. Subsequently, the patients were followed-up for up to significant further increase in the cure rate 7 years after ending therapy, again greater than the expected 7 years. Close contact was maintained with the families over this period ('good doctoring' approach). At spontaneous cure rate. There also seemed to be a better response to treatment when it was prolonged. #3-, 5-and 7-year intervals after completing the study, patients were assessed for dryness, frequency, Furthermore, this therapy is safe when administered in the long-term. treatment and sleeping habits, using postal questionnaires and telephone follow-up. Keywords Desmopressin, long-term follow-up, nocturnal enuresis Results At the end of the long-term study, 35% of the may represent one of several contributing factors [7,8].
Treatment with Desmopressin in Severe Nocturnal Enuresis in Childhood
British Journal of Urology, 1990
A series of 22 patients with severe nocturnal enuresis were treated with desmopressin in a randomised double-blind cross-over study. Treatment with 20 and 40 pg was highly effective compared with placebo. No difference in dry nights was found between the 2 dosages.
Research and Reports in Urology, 2019
The aim of this study was to compare the efficacy and safety of desmopressin and imipramine in the treatment of severe primary nocturnal enuresis (NE) in Taiwan. Patients and methods: This study was a retrospective chart review study conducted on children with primary monosymptomatic nocturnal enuresis (PMNE) or non-monosymptomatic nocturnal enuresis (PNMNE), referred to and treated by senior physicians in a Changhua medical center in Taiwan. After being screened, these children were treated with either desmopressin (n = 125) or imipramine (n = 71). All participants were treated for at least 3 months and followed afterward for at least 3 more months. The response and relapse rates were measured. Side effects were monitored. Age, gender, and severity of NE were recorded. Results: After 3 months of treatment, 97 children treated with desmopressin were responsive (77.6%) while 58 children treated with imipramine were responsive (81.7%). Sixty-one children treated with desmopressin (48.8%) and 26 treated with imipramine (36.6%) relapsed during the 3month post-treatment monitoring. The differences in responsive and relapse rates were not statistically significant. Four children treated with imipramine (5.6%) reported side effects while none was reported for children treated with desmopressin (P < 0.05). Age, gender, and the presence or absence of daytime enuresis did not influence the response rate to either drug (P < 0.05). Conclusion: Currently, desmopressin is preferred over imipramine for treating NE due to the latter's side effects. Our results demonstrated similar response rates for both drugs, with imipramine demonstrating minimal side effects. While health practitioners should pay attention to its side effects, concerns regarding imipramine toxicity in NE treatment are often overblown. Since imipramine is much cheaper than desmopressin, using imipramine to manage NE can allow health practitioners, especially in Taiwan, to treat the greatest number of children with NE.
Insight Urology, 2021
Objective: The negative consequences of enuresis in children can be far reaching and an understanding of the impact of these is essential for effective treatment by the clinician. Enuresis can be categorized into monosymptomatic nocturnal enuresis (MNE) and non-monosymptomatic nocturnal enuresis (NMNE). There have been several studies in treatment of MNE with lyophilizate desmopressin melt but very limited research into the efficacy of desmopressin melt in treating NMME. The objectives of this study were to measure the efficacy and side effects of desmopressin melt in treating children with NMNE. Materials and Methods: Children aged 6 to 18 years with NMNE who visited the outpatient department of pediatric urology were included in this prospective study. Any underlying diseases and lower urinary tract symptoms were corrected then their enuresis was treated with 120-240 mcg of desmopressin melt for 6-8 weeks. Outcomes were defined as complete response, partial response, and no-respon...
Long-term treatment of nocturnal enuresis with desmopressin. A follow-up study
Urological Research
Eight patients with m o n o s y m p t o m a t i c nocturnal enuresis (age 11-24 years) were investigated prior to and after 24 weeks of desmopressin treatment in order to evaluate the impact on the endogenous vasopressin secretion and urinary output. No effect on plasma vasopressin, diurnal urinary volume, and urinary osmolality were found after this long-term treatment. Overall no changes in either b o d y weight, blood pressure, or hematological variables were demonstrated. This supports previous findings that the treatment appears to be well tolerated and free of side effects in longer term.
Is There Still a Role for Desmopressin in Children with Primary Monosymptomatic Nocturnal Enuresis?
Drug Safety, 2010
it has recently became apparent that severe primary monosymptomatic nocturnal enuresis (MNE) has a worse prognosis than generally believed, and may have major consequences on the well-being of the child, thus making treatment mandatory. Desmopressin is one of the most widely prescribed medications for MNE, and in this current opinion article we discuss the safety of desmopressin in children with this condition.
Journal of renal injury prevention, 2015
Nocturnal enuresis (enuresis) is one of the most common developmental problems of childhood, which has often a familial basis, causes mental and psychological damage to the child and disrupts family solace. In this study, we compared therapeutic effects of combination therapy of desmopressin plus oxybutynin with desmopressin plus tolterodine, in the treatment of children with primary nocturnal enuresis. The present study is a clinical trial study, where 59 patients with primary nocturnal enuresis in the age range of 5 to 14 years old were selected from the visitors of nephrology clinic of Dr. Sheikh pediatrics hospital (Mashhad, Iran). Patients were divided into 2 treatment groups where the first group received combined therapy with desmopressin and oxybutynin, and the second group received combined therapy with desmopressin and tolterodine. Data was analyzed using SPSS 16 software and descriptive and analytical statistics (chi-square test). The mean of age of patients in total was ...
Long-term treatment of nocturnal enuresis with desmopressin
Urological Research, 1991
Eight patients with m o n o s y m p t o m a t i c nocturnal enuresis (age 11-24 years) were investigated prior to and after 24 weeks of desmopressin treatment in order to evaluate the impact on the endogenous vasopressin secretion and urinary output. No effect on plasma vasopressin, diurnal urinary volume, and urinary osmolality were found after this long-term treatment. Overall no changes in either b o d y weight, blood pressure, or hematological variables were demonstrated. This supports previous findings that the treatment appears to be well tolerated and free of side effects in longer term.
Treatment of Nocturnal Enuresis in Children With Attention Deficit Hyperactivity Disorder
Journal of Urology, 2007
Purpose: Children with attention deficit hyperactivity disorder disproportionately experience voiding dysfunction and persistent nocturnal enuresis due to a combination of sphincter and detrusor overactivity and nocturnal polyuria. The different treatment approaches to nocturnal enuresis often fail in these patients. Therefore, we performed a prospective study to compare the efficacy of combination therapy with desmopressin and oxybutynin vs the tricyclic antidepressant imipramine in patients with attention deficit hyperactivity disorder who have nocturnal enuresis. Materials and Methods: A total of 54 patients with attention deficit hyperactivity disorder and nocturnal enuresis were randomly stratified into 2 groups. Demographic data on patient age and gender were identical in the 2 groups. Functional bladder symptoms were judged using the dysfunctional voiding symptoms survey. The initial dysfunctional voiding symptoms survey score was similar in the 2 groups. The total survey score was compared between the 2 groups in aggregate as well as specifically regarding the incidence of nocturnal enuresis following treatment. Results: The first group consisted of 27 patients who received desmopressin and oxybutynin, and the second group of 27 was treated with imipramine. Of the 27 children in each group 23 (85%) received methylphenidate for attention deficit hyperactivity disorder. The mean Ϯ SD initial dysfunctional voiding symptoms survey score in groups 1 and 2 was 20.5 Ϯ 3.3 and 20.9 Ϯ 4.1, respectively. Following treatment the mean survey score decreased significantly in groups 1 and 2 (6.5 Ϯ 2.5 and 9.4 Ϯ 2.1, respectively, p Ͻ0.001). However, between groups analysis showed that the dysfunctional voiding symptoms survey score was significantly lower in group 1 than in group 2 (mean 6.5 Ϯ 0.5 vs 9.6 Ϯ 0.4, p Ͻ0.001). There was also a statistically significant decrease in the incidence of nocturnal enuresis in group 1 (survey question 2 score 0.9 Ϯ 0.2 vs 2.9 Ϯ 0.2). Conclusions: Our data show that there is a high incidence of voiding dysfunction in children with attention deficit hyperactivity disorder. Combination therapy with desmopressin and oxybutynin is a feasible, safe and effective treatment for nocturnal enuresis in these children.