Desmopressin melt improves sleep and psychological functioning in patients with monosymptomatic nocturnal enuresis (original) (raw)
Related papers
Nocturnal polyuria in monosymptomatic nocturnal enuresis refractory to desmopressin treatment
American Journal of Physiology-Renal Physiology, 2006
The transition from day to night is associated with a pronounced decline in diuresis with reductions in the amount of excreted water, electrolytes, and other end products of our metabolism. Failure to do so leads to a large urine output at night, a condition known as nocturnal polyuria, encountered in a large proportion of children with nocturnal enuresis. The aim of this study was to clarify the mechanisms responsible for the nocturnal polyuria seen in enuretics with inadequate response to desmopressin (dDAVP). Forty-six enuretics (7–14 yr of age) and fifteen age-matched controls were admitted for a 24-h protocol with standardized fluid and sodium intake, comprising urine collections, blood sampling, and blood pressure monitoring. We included patients with severe enuresis (5 ± 1 wet nights/wk) showing <50% reduction in wet nights on dDAVP. We characterized the patients on the basis of their nocturnal urine production. The children with nocturnal polyuria excreted larger amounts ...
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.
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...
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 ...
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.
The Journal of Urology, 1996
Purpose: The relationship of functional bladder capacity as well as other variables to the responsiveness to desmopressin in children with monosymptomatic nocturnal enuresis was investigated. Materials and Methods: A total of 95 children 8 to 14 years old with monosymptomatic nocturnal enuresis (6 or more of 14 nights wet) were evaluated in a double-blind study followed by open label crossover extension using 20 to 40 mcg. desmopressin. Evaluated predictors of response included patient age, gender, race, family history, number of baseline wet nights, urine osmolality parameters and maximum functional bladder capacity (as a percent of predicted bladder capacity based on the formula, patient age + 2 X 30 = cc). Responders to desmopressin were classified as excellent (2 or less of 14 nights wet) or good (50% or greater decrease but more than 2 of 14 nights wet) and nonresponders were defined by a less than 50% decrease in wet nights. Results: Of the 95 patients 25 (29.5%) achieved an excellent response to desmopressin and 18 (18.9%) had a good response for a cumulative response rate of 45.3%. The remaining 52 patients (54.7%) were nonresponders. There were no significant differences between responders and nonresponders in regard to gender, race, positive family history or baseline urine osmolality parameters. Response to desmopressin was associated with older age, fewer baseline wet nights and larger bladder capacity. Patients with a functional bladder capacity greater than 70% predicted bladder capacity were 2 times more likely to respond to desmopressin. Conclusions: The responsiveness of children with nocturnal enuresis to desmopressin is adversely affected by reduced functional bladder capacity. The results of this study have implications regarding the potential use of combination pharmacotherapy with desmopressin and an anticholinergic for enuretic patients who are nonresponsive to single drug therapy.
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.
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.
Electronic physician, 2016
Background: Nocturnal enuresis is among the most common disorders in children. Several pharmacological and non-pharmacological treatments are available for nocturnal enuresis. Studies for reaching the best pharmacological treatment for this disorder are continuing. Objective: To compare the effectiveness and safety of Desmopressin and oxybutynin for treatment of nocturnal enuresis in children from Bandar Abbas in 2014. Methods: This randomized controlled trial was conducted in 2014 and participants included 66 children with nocturnal enuresis who were more than 5 years old. Patients were randomly assigned into two groups. The first group received 120 microgram Desmopressin daily for 2 months, then 60 microgram daily for 2 months, then 60 microgram every 2 days. The second group received 5 mg oxybutynin twice a day for 6 months. The patients were followed after 1, 3, and 6 months to track treatment response. The study outcomes were frequency of nocturnal enuresis, urinary incontinency, urgency, and frequency. Data were analyzed using SPSS software. Results: There were no significant differences between the two groups with respects to sex, age, place of residence, and parents' education (p<0.05). Nocturnal enuresis, incontinency, urgency, and frequency of nocturnal enuresis was significantly lower with Desmopressin treatment in comparison to the oxybutynin treated group after 1 and 3 months (p<0.05). In addition, constipation and xerostomia were more frequent among the oxybutynin group after 1, 3, and 6 months (p<0.01). Blurred vision was also more frequent among oxybutynin group after 3 months (p<0.01). After 6 months the frequency of nocturnal enuresis and its frequency was higher in oxybutynin group in comparison to the Desmopressin group (p<0.05). Conclusion: Desmopressin is more effective and has lower rate of side effects in comparison to oxybutynin for treatment of nocturnal enuresis. We recommend using Desmopressin for treatment of nocturnal enuresis in children. More studies are needed to achieve the best pharmacological treatment option for treatment of nocturnal enuresis. Trial registration: The trial is registered at ClinicalTrials.gov with a ClinicalTrials.gov Identifier: NCT02538302 Funding: The funder of this research is Hormozgan University of Medical Sciences.