Combination of the enuresis alarm and desmopressin: second line treatment for nocturnal enuresis.
OBJECTIVE
We sought to evaluate the combination of the enuresis alarm and desmopressin in treating children with enuresis.


METHODS
A retrospective analysis was performed on data from 423 children treated at our clinics with the enuresis alarm during the years 2000 to 2004. Frequency volume charts and desmopressin titration facilitated characterization of the participants using the current International Children's Continence Society standardization. Children were treated with the enuresis alarm as monotherapy before the addition of desmopressin, which commenced after 6 weeks in patients exhibiting inadequate response to alarm or after 2 weeks in patients experiencing multiple enuretic episodes per night or showing no indication of improvement.


RESULTS
Of the initial population 315 children (74%) were treated only with alarm, of whom 290 became dry. A total of 108 children (26%) were treated with a combination of alarm and desmopressin, with 80 being cured. Children dry on alarm therapy were not different from those needing the addition of desmopressin in terms of demographics. Children dry on desmopressin plus alarm had higher average nocturnal urine production on wet nights (303 +/- 12 ml compared to 269 +/- 5 ml, p <0.001). Maximum voided volume before treatment corrected for age was not different between children dry on alarm and those dry on combination therapy (0.84 +/- 0.02 compared to 0.86 +/- 0.05, not significant).


CONCLUSIONS
Children needing the addition of desmopressin have a higher nocturnal urine production on wet nights but do not seem to differ in terms of bladder reservoir function characteristics.
Kamperis
Konstantinos
K
Clinical Institute, University of Aarhus and Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark. kostas.kamperis@ki.au.dk
Hagstroem
Soren
S
Rittig
Soren
S
Djurhuus
Jens C
JC
D050034:Antidiuretic Agents / Q000627:therapeutic use*; D001521:Behavior Therapy; D002648:Child; D003131:Combined Modality Therapy; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D053206:Nocturnal Enuresis / Q000628:therapy*; D012189:Retrospective Studies; D014039:Toilet Training
D050034:Antidiuretic Agents; D003894:Deamino Arginine Vasopressin