Predictors of Success and Relapse after Desmopressin Monotherapy for Monosymptomatic Nocturnal Enuresis

Abstract

Background: Enuresis in children can have serious negative effects, and a doctor must be aware of these effects in order to effectively  manage the patient. Enuresis can be divided into two types: monosymptomatic nocturnal enuresis (MNE) and non-monosymptomatic  nocturnal enuresis (NMNE).

Objective: This study aimed to assess desmopressin's effectiveness in treating PMNE in children.

Patients and methods: This prospective cohort study included children with primary monosymptomatic nocturnal enuresis (PMNE)  aged  7 to 14 years who went to The Pediatric Urology Outpatient Clinic. Desmopressin 0.2 mg was given orally once a day, just before  bed, for 3 months. According to the International Children's Continence Society's criteria. Outcomes were classified as full response,  partial response, and no response. Desmopressin therapy was discontinued after three months of treatment, and patients were checked  again after one month to look for signs of relapse.

Results: The study involved a total of 50 children with PMNE. The results revealed that  20% of patients responded fully, 64% partially, and 16% did not respond at all. Desmopressin treatment resulted in a positive response  from the patients, with a mean number of episodes per week considerably decreasing from 5.96 ± 1.32 to 1.92 ± 1.140 (p 0.001). After one  month of therapy discontinuation, the mean number of episodes per week increased considerably from 1.92 ± 1.140 to 2.66 ± 2.22 (p  value 0.041).

Conclusion: Desmopressin is effective in reducing the number of wet nights each week in children with primary MNE. Although it has the advantage of acting more quickly, it has a high rate of relapse. Therefore, additional studies involving more patients  should be considered.