title: Combined laser acupuncture and desmopressin for treating resistant cases of monosymptomatic nocturnal enuresis: a randomized comparative study.
abstract: OBJECTIVE
  Monosymptomatic nocturnal enuresis (MNE) is a common sociomedical problem affecting children that may persist until adulthood despite various lines of therapy. The aim of this study was to assess the efficacy of combined laser acupuncture and desmopressin in managing patients with resistant MNE, compared with their efficacy when used as monotherapy.
  
  
  METHODS
  The study included 186 patients with a mean age of 15.7 years (range 10-21 years) presenting with persistent MNE. All patients were evaluated clinically and investigated with urine analysis, plain X-ray of the urinary tract and abdominal ultrasonography. They were randomized into three equal groups based on the line of management: group A, managed with laser acupuncture alone; group B, managed with desmopressin alone; and group C, managed with a combination of laser acupuncture and desmopressin, with a treatment course of 3 months and follow-up period of 6 months to record the efficacy of therapy, side-effects and bladder capacity.
  
  
  RESULTS
  A statistically significant higher cure rate was reported in group C patients, being reported in 33, 35 and 46 patients in groups A, B and C, respectively. Improvement was reported in 18, 17 and 13 cases in groups A, B and C, respectively, but the difference was not statistically significant. Bladder capacity significantly increased only in patients receiving acupuncture (groups A and C).
  
  
  CONCLUSIONS
  Combined laser acupuncture and desmopressin is a promising and valid option to manage resistant cases of MNE.
authors.affiliation: Urology Department, Sohag Faculty of Medicine , Sohag , Egypt.
authors.forename: Essam Eldin S
authors.initials: EE
authors.lastname: Moursy
authors.forename: Naglaa F
authors.initials: NF
authors.lastname: Kamel
authors.forename: Ahmed F
authors.initials: AF
authors.lastname: Kaseem
mesh_terms: D015670:Acupuncture Therapy / Q000009:adverse effects / Q000379:methods*; D000293:Adolescent; D050034:Antidiuretic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D003131:Combined Modality Therapy / Q000009:adverse effects; D003894:Deamino Arginine Vasopressin / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D054023:Lasers, Semiconductor / Q000627:therapeutic use*; D008297:Male; D053206:Nocturnal Enuresis / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D050034:Antidiuretic Agents; D003894:Deamino Arginine Vasopressin
keywords: desmopressin; laser acupuncture; monosymptomatic nocturnal enuresis.