Desmopressin for the treatment of nocturnal bedwetting in patients with neural tube closure defects.
OBJECTIVE
We evaluated desmopressin (DDAVP) treatment in patients with neuropathic bladder secondary to neural tube closure defects (NTDs) and nocturnal incontinence.


METHODS
We selected 25 patients, that is 10 males (40%) and 15 females (60%), between ages 7 and 16 years (mean 9.8) with neuropathic bladder secondary to NTDs without a ventricular-peritoneal shunt. All had a low pressure bladder and presented with daytime continence between catheterizations but had persistent nocturnal urine loss 7 nights weekly. They underwent treatment with oral DDAVP according to a certain design, namely an initial dose of 0.2 mg for 3 weeks, which was increased to 0.3 or 0.4 mg for another 3 weeks in nonresponders. The average dose was 0.2 mg. At the effective minimal dose (bedwetting decrease greater than 50%) patients continued for 6 months and then decreased by intervals of 0.05 mg every 2 weeks. In the event of recurrence treatment continued for 1 year.


RESULTS
All patients responded to treatment during the nighttime hours except 1 who suspended treatment after 4 weeks. There were no adverse effects from DDAVP.


CONCLUSIONS
Treating nocturnal bedwetting with DDAVP in patients with NTDs was effective and safe. Nevertheless, to our knowledge treatment duration has not yet been determined.
Del Gado
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R
Paediatrics Department, University of Bari, Bari, Italy. roberto.delgado@unina2.it
Aceto
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Del Gaizo
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D
Del Gado
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Polidori
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Chiozza
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ML
D000293:Adolescent; D002648:Child; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use*; D004775:Enuresis / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D009436:Neural Tube Defects / Q000150:complications; D012076:Renal Agents / Q000627:therapeutic use*; D001750:Urinary Bladder, Neurogenic / Q000150:complications / Q000209:etiology
D012076:Renal Agents; D003894:Deamino Arginine Vasopressin