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Alarm therapy plus desmopressin helps achieve dryness in children with enuresis, study finds

Tuesday, October 14 2008 | Comments
Evidence Grade 7 What's This?
By Patrice LaVigne

Combination therapy with desmopressin and alarm therapy appears to be effective in children with monosymptomatic nocturnal enuresis, regardless of which approach was administered first, new data show.

Dr. Udo Rolle from the Department of Pediatric Surgery at the University of Leipzig in Leipzig, Germany, presented the results of the prospective study in a poster session.

From October 2004 through July 2006, children aged from 5 to 13 years with monosymptomatic nocturnal enuresis were randomized to 2 combination therapy groups after receiving the standardized treatment course of 6 months. In Group A, 16 children were treated with the antidiuretic desmopressin for 3 months, after which desmopressin was combined with alarm therapy. In Group B, 14 children initially underwent alarm therapy for 3 months, and then received combination therapy with alarm therapy plus desmopressin.

Eleven patients (69%) in Group A and 11 patients (78%) in Group B achieved dryness, described as a maximum of 2 wet nights per month, after 6 months. Dr. Rolle noted that there were no statistically significant differences observed between the 2 treatment modes, although primary alarm therapy followed by subsequent combination therapy with desmopressin seemed superior.

Certain patient subgroups, however, responded better to the combination therapy. Compared with boys (66%), 83% of girls reached dryness after combination treatment. Furthermore, children with normal bladder capacity became dry at 6 months as compared with children who had reduced bladder capacity (79% vs 50%). Lastly, 68% of patients with nocturnal polyuria compared with 82% of those without nocturnal polyuria achieved dryness.

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