Therapy of Primary Nocturnal Enuresis by Alarm in Patients Previously Treated with Desmopressin

Overview

Introduction:
In the treatment of primary nocturnal monosymptomatic enuresis different therapeutic proceduresare applied.Objective: Assessment whether alarm therapy can be successful in patients with a relapse of enuresis aftercompleted desmopressin therapy.Patients and methods: In 1999 - 2000 the authors included 42 patients with primary monosymptomaticnocturnal enuresis in their study. Before the investigation started every patient had at leat one year of follow up, 6and more (median 8.2) unsuccessful desmopressin therapies and a frequency of enuresis twice a week or moreoften. The training of alarm therapy in the family took 2 - 3 weeks. As criterion of success an enuretic calendarwas used.Results: The investigation was completed by all 42 children aged 7 - 11 years (median 8.4). A total of 36 (85.7%)patients achieved in the course of 8 - 27 weeks (median 24.6) following the beginning of alarm therapy a 30-daydry interval after which treatment was discontinued. A relapse occurred in 3 (14%) patients, in another 6 (28%)during the 12-month follow up. Reinstallation of treatment led to regression of enuresis.Conclusion: Unsuccessful treatment of primary nocturnal enuresis by nasal desmopressin administration doesnot rule out highly successful alarm treatment.

Key words:
enuresis, desmopressin, alarms, alarm therapy