title: Efficacy of an enuresis alarm, desmopressin, and combination therapy in the treatment of saudi children with primary monosymptomatic nocturnal enuresis.
abstract: OBJECTIVE
  We evaluated and compared the effectiveness of an enuresis alarm, desmopressin medication, and their combination in the treatment of Saudi children with primary monosymptomatic nocturnal enuresis (PMNE).
  
  
  METHODS
  A total of 136 children with PMNE were randomly assigned to receive an enuresis alarm alone (EA group, n=45), desmopressin alone (D group, n=46), or a combination of both (EA/D group, n=45). Patients were followed weekly during treatment and for 12 weeks after treatment withdrawal.
  
  
  RESULTS
  During treatment, wetting frequencies were significantly reduced in all groups and remained significantly lower than pretreatment values until the end of follow-up. In the D and EA/D groups, an immediate reduction in wetting frequencies was observed, whereas a longer time was required to reach a significant reduction in the EA group. The full and partial response rates were 13.3% and 37.8% in the EA group, 26.1% and 43.5% in the D group, and 40.0% and 33.3% in the EA/D group. A significant difference was observed only between the EA and EA/D groups (p=0.025). Relapse rates were higher in the D group (66.6%) than in the EA (16.6%) and EA/D (33.3%) groups. A significant difference was observed between the D and EA groups only (p=0.019).
  
  
  CONCLUSIONS
  Desmopressin, an enuresis alarm, and combined therapy are effective in the treatment of Saudi children with PMNE. Desmopressin produced an immediate effect but relapses were common. The enuresis alarm provided gradual effects that persisted posttreatment. The combined therapy was superior to the alarm in achieving an immediate response; however, its effect was not better than that of the alarm long term.
authors.affiliation: Department of Urology, Al-Azhar University, Cairo, Egypt. ; Department of Urology, Salman Bin Abdul-Aziz University, Al-Kharj, Kingdom of Saudi Arabia.
authors.forename: Abul-Fotouh Abdel-Maguid
authors.initials: AF
authors.lastname: Ahmed
authors.forename: Moamen Mohammed
authors.initials: MM
authors.lastname: Amin
authors.forename: Mahmoud Mohammed
authors.initials: MM
authors.lastname: Ali
authors.forename: Essam Abdel-Moneim
authors.initials: EA
authors.lastname: Shalaby
keywords: Combined modality therapy; Nocturnal enuresis; Treatment efficacy