title: Desmopressin versus indomethacin treatment in primary nocturnal enuresis and the role of prostaglandins.
abstract: OBJECTIVE
  To compare the efficacy of desmopressin and indomethacin and also determine the prostaglandin E2 (PGE2) concentrations in the patient and control groups.
  
  
  METHODS
  Eighty-five children with primary nocturnal enuresis were followed up for a baseline period of 4 weeks, during which they recorded wet and dry nights. After this period, the patients were divided into three groups that used desmopressin, indomethacin, or placebo for 4 weeks. The dosage of desmopressin (group A, n = 31 ) was 20 microg/day and the dosage of indomethacin (group B, n = 29) was 100 mg/day. The placebo group (group C) consisted of 25 patients. We determined the serum PGE2 and urine PGE2 concentrations before and after treatment in the three groups and in a control group.
  
  
  RESULTS
  Treatment with desmopressin and indomethacin resulted in significantly more dry nights during the 4 weeks of observation than did placebo (P <0.005). The number of dry nights was also significantly different in the desmopressin group than in the indomethacin group (P <0.01). In the total patient group, the mean serum and urine PGE2 concentrations were significantly different from the control group's serum and urine PGE2 concentrations (P <0.001). There was a significant decrease in the serum and urine PGE2 concentrations in group A and group B after the treatment period (P <0.01).
  
  
  CONCLUSIONS
  Desmopressin and indomethacin were found to be more effective than placebo. We conclude that prostaglandins have an important role in the pathophysiology of primary nocturnal enuresis.
authors.affiliation: Department of Pediatric Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: F
authors.initials: F
authors.lastname: Sener
authors.forename: E
authors.initials: E
authors.lastname: Hasanoğlu
authors.forename: O
authors.initials: O
authors.lastname: Söylemezoğlu
mesh_terms: D000293:Adolescent; D002648:Child; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use*; D015232:Dinoprostone / Q000378:metabolism*; D004775:Enuresis / Q000188:drug therapy* / Q000378:metabolism; D005500:Follow-Up Studies; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use*; D012076:Renal Agents / Q000627:therapeutic use*
chemical_list: D012076:Renal Agents; D003894:Deamino Arginine Vasopressin; D015232:Dinoprostone; D007213:Indomethacin