The Desmopressin melt therapy in children with non-monosymptomatic nocturnal enuresis: a prospective study

Abstract

Objective: The negative consequences of enuresis in children can be far reaching and an understanding of the impact of these is essential for effective treatment by the clinician. Enuresis can be categorized into monosymptomatic nocturnal enuresis (MNE) and non-monosymptomatic nocturnal enuresis (NMNE). There have been several studies in treatment of MNE with lyophilizate desmopressin melt but very limited research into the efficacy of desmopressin melt in treating NMME. The objectives of this study were to measure the efficacy and side effects of desmopressin melt in treating children with NMNE. Materials and Methods: Children aged 6 to 18 years with NMNE who visited the outpatient department of pediatric urology were included in this prospective study. Any underlying diseases and lower urinary tract symptoms were corrected then their enuresis was treated with 120-240 mcg of desmopressin melt for 6-8 weeks. Outcomes were defined as complete response, partial response, and no-response as defined by the International Children’s Continence Society guidelines. Results: A total of 25 children with NMNE were included in the study. The results showed 44% complete response, 20% partial response, and 36% no-response. The mean volume of nocturnal enuresis decreased from 159.96 to 115.30 ml in the pre and post treatment periods, respectively (p = 0.012). The mean frequency of enuresis decreased from 4.36 to 2.84 days per week in pre and post treatment periods, respectively (p < 0.001). The mean whole night urine volume decreased from 373.39 to 292.37 ml in pre and post treatment periods (p = 0.061). There were no major side effects in the study. Conclusion: Desmopressin melt is effective and safe in treating NMNE in children. However, to add weight to the findings of this study further research with a larger number of patients should be considered in the near future.