Efficacy of an Enuresis Alarm, Desmopressin, and Combination Therapy in the Treatment of Saudi Children With Primary Monosymptomatic Nocturnal Enuresis

Abstract

PurposeWe evaluated and compared the effectiveness of an enuresis alarm, desmopressin medication, and their combination in the treatment of Saudi children with primary monosymptomatic nocturnal enuresis (PMNE).Materials and MethodsA total of 136 children with PMNE were randomly assigned to receive an enuresis alarm alone (EA group, n=45), desmopressin alone (D group, n=46), or a combination of both (EA/D group, n=45). Patients were followed weekly during treatment and for 12 weeks after treatment withdrawal.ResultsDuring treatment, wetting frequencies were significantly reduced in all groups and remained significantly lower than pretreatment values until the end of follow-up. In the D and EA/D groups, an immediate reduction in wetting frequencies was observed, whereas a longer time was required to reach a significant reduction in the EA group. The full and partial response rates were 13.3% and 37.8% in the EA group, 26.1% and 43.5% in the D group, and 40.0% and 33.3% in the EA/D group. A significant difference was observed only between the EA and EA/D groups (p=0.025). Relapse rates were higher in the D group (66.6%) than in the EA (16.6%) and EA/D (33.3%) groups. A significant difference was observed between the D and EA groups only (p=0.019).ConclusionsDesmopressin, an enuresis alarm, and combined therapy are effective in the treatment of Saudi children with PMNE. Desmopressin produced an immediate effect but relapses were common. The enuresis alarm provided gradual effects that persisted posttreatment. The combined therapy was superior to the alarm in achieving an immediate response; however, its effect was not better than that of the alarm long term.

Additional Use of Alarm Systems in Wakefulness in the Treatment of Mono-Symptomatic Nocturnal Enuresis

“…The results of OAB-q questionnaire survey: average score in-group А -2.3, in group В -1.9, patients with Nevertheless, in spite of long history of application 28 this method often does not bring to desired effect. Attempts to improve the schemes of alarm systems use are also being made nowadays 29,30,31,32,33 .…”

Sensibility of Children of Different Age Groups to Alarm Intervention for Enuresis

“…In their review of enuresis therapy methods, based on the results of eight recent studies, Perrin N et al (2013) report that prolonged use of the Alarm interven on achieves be er results than taking desmopressin 30 . Ahmed AF et al (2013) also point out to be er result achieved by using signal systems and its higher survival, compared to desmopressin, which can be interpreted as important indirect evidence of delay of autonomic nerve system development among children of younger age 31 .…”

Comparison of desmopressin, alarm, desmopressin plus alarm, and desmopressin plus anticholinergic agents in the management of paediatric monosymptomatic nocturnal enuresis: a network meta‐analysis

“…After removing duplicates, 1 625 studies were screened by reading titles and abstracts. Full-text assessment was carried out on a total 57 articles, and a final total of 18 [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] RCTs with 1 649 patients was included in the present analysis.…”

“…In their study comparing desmopressin and alarm therapy, Fera et al [17] observed no adverse events in either group. Also, no adverse events were found in two trials [20,21] comparing desmopressin plus alarm with alarm or desmopressin monotherapy. Five of six studies described adverse events for desmopressin plus AA.…”