Objective To measure the eÂect of intranasal desmopres-The response was better in older patients and in those with less frequent enuresis. The mean and peak urisin (1-deamino 8-d-arginine vasopressin, DDAVP) on urine osmolality in a group of patients with persistent nary osmolality of the morning urine samples were higher while on treatment with DDAVP compared primary enuresis, and to determine whether changes in osmolality can the predict response to treatment.with placebo, but this diÂerence was not statistically significant and the response did not predict a good Patients and methods Thirty-seven patients with persistent primary nocturnal enuresis were entered into a clinical outcome in improving the enuresis. Conclusions Treatment with DDAVP can produce a socidouble-blind placebo-controlled crossover trial of 20 mg intranasal DDAVP spray. Morning urinary ally acceptable level of dryness in some patients with refractory nocturnal enuresis. However, the early osmolality was measured on two occasions during each phase of treatment and the clinical response morning urinary osmolality, as a reflection of changes in nocturnal osmolality, was not useful in disrecorded in a diary. Results Thirty-one patients (22 males and nine females) tinguishing this group or in selecting those who will respond to treatment. were evaluable at the end of the trial period. A good clinical response, defined as enuresis on two nights or Keywords Enuresis, desmopressin, DDAVP, urinary osmolar concentration, continence fewer each week, occurred in 12 of 31 (39%) patients, but complete continence was attained in only two. urine osmolality [7,8] although there is considerable
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