title: Evaluation of different modes of combined therapy in children with monosymptomatic nocturnal enuresis.
abstract: 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.
authors.affiliation: Department of Paediatric Surgery, University of Leipzig, Leipzig, Germany.
authors.forename: Mandy
authors.initials: M
authors.lastname: Vogt
authors.forename: Thomas
authors.initials: T
authors.lastname: Lehnert
authors.forename: Holger
authors.initials: H
authors.lastname: Till
authors.forename: Udo
authors.initials: U
authors.lastname: Rolle
mesh_terms: 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
chemical_list: D050034:Antidiuretic Agents; D003894:Deamino Arginine Vasopressin