Desmopressin for nocturnal enuresis: urinary osmolality and response

Abstract

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

Enuresis Prevalence and Accompanying Factors in Schoolchildren: A Questionnaire Study from Southeast Anatolia

“…A low functional bladder capacity, relative polyuria, and urodynamic abnormalities, such as bladder instability and dysfunctional voiding, may result in frequent urination. A low functional bladder capacity occurs in almost all enuretic children, and to increase the functional bladder capacity is, therefore, a therapeutic goal in patients having enuresis [1,27,28].…”

Enuresis in Children and Young People: a Public Health Nurse Approach in New Zealand

“…A good success rate was found when using both DDAVP and an alarm program in children who had previously failed when they had tried either of these methods separately (Folwell et al, 1997;Moffatt, 1997). Bath et al (1996) concluded that if a course (in this case, four months) with an enuretic alarm is unsuccessful, it is better to consider the use of the dry-bed training technique instead of Desmopressin for those children under 9-years-old.…”

Characteristics of a Tertiary Center Enuresis Population, With Special Emphasis on the Relation Among Nocturnal Diuresis, Functional Bladder Capacity and Desmopressin Response

“…18 Some authors have found a positive correlation between age and response to desmopressin treatment, while others have noted a positive correlation between fewer baseline wet nights and improved response to desmopressin. 4,5,12 The first observation is certainly valuable, since one can assume that younger children are more prone to have a small FBC and/or bladder overactivity, which is a well known factor behind inadequate desmopressin response. 4,19 Our data support this observation, since the MNE-SB group was significantly younger than the MNE-NP group.…”