Evaluation of different modes of combined therapy in children with monosymptomatic nocturnal enuresis.
OBJECTIVE
To evaluate the efficacy of different modes of combined therapy in children with monosymptomatic nocturnal enuresis (MNE).


METHODS
A randomized prospective study was performed to compare the order of two types of combined therapy in children with MNE. Group A was treated with primary desmopressin treatment that was combined with alarm treatment after 3 months, while group B was treated with primary alarm treatment that was combined with desmopressin after 3 months.


RESULTS
Within a period of 18 months, 43 previously untreated children fulfilled the inclusion criteria. Thirteen children achieved dryness after initial monotherapy or discontinued the study. Group A consisted of 16 children and group B of 14 children. After the standardized treatment course of 6 months, 11/16 children in group A and 11/14 children in group B became dry (<3 wet nights/month). Altogether, 22/30 (73%) children were dry after combined treatment, consisting of 12/18 boys and 10/12 girls. Of the children with a normal maximum voided volume, 79% (19/24) achieved dryness, whereas only three of six children with small maximum voided volumes became dry. In all, 13/19 (68%) children with nocturnal polyuria and nine of 11 without nocturnal polyuria became dry. Only one child relapsed (group A).


CONCLUSIONS
Combined therapy proved effective in children with MNE after 6 months, with no statistically significant differences between the two different orders of treatment.
Vogt
Mandy
M
Department of Paediatric Surgery, University of Leipzig, Leipzig, Germany.
Lehnert
Thomas
T
Till
Holger
H
Rolle
Udo
U
D000293:Adolescent; D050034:Antidiuretic Agents / Q000627:therapeutic use*; D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D053206:Nocturnal Enuresis / Q000628:therapy*; D011446:Prospective Studies
D050034:Antidiuretic Agents; D003894:Deamino Arginine Vasopressin