Desmopressin versus indomethacin treatment in primary nocturnal enuresis and the role of prostaglandins.
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.
Sener
F
F
Department of Pediatric Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey.
Hasanoğlu
E
E
Söylemezoğlu
O
O
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*
D012076:Renal Agents; D003894:Deamino Arginine Vasopressin; D015232:Dinoprostone; D007213:Indomethacin