Long-term Treatment with Desmopressin in Children withPrimary Nocturnal Enuresis - International Multicentre Study

Overview

Background.
Desmopressin (an analogue of antidiuretic hormone) holds an important place in the treatment ofprimary nocturnal enuresis. According to some long-term trials its action is mainly symptomatic. The benefit oftreatment and persistence of the effect in relation to the expected decline of enuresis in 15% children/1 year isdiscussed.Methods and Results. The open multicentre trial lasted 42 months. In the first stage 265 patients (164 boys, 101girls) aged 9.4 ± 2.8 (5 - 18 years) were given desmopressin (nasal drops) to achieve a 4-week dry interal. Enuresisstopped in 207/265 (78.1%) children within six (median) weeks of treatment after an effective dose of 10.5 mg(median) based on titration. During the second stage 55/265 children (25 boys and 30 girls) proceeded with treatmentfor 2 - 30 (median 12) months, one boy did not complete the trial. An effective dose was administered for 3.5 months(median) and then the dose declined depending on the effect by 3.5 mg (1 drop) per months (median). In the titrationstage enuresis receded in 89.1% (49/55) children. After the first year of the trial there were 72.7% responders (p

Key words:
primary nocturnal enuresis, desmopressin, long-term treatment, undesirable effects, osmolality ofurine.