Evaluation of Theraputic Effect of Desmopressin on Enuresis in Children

Background & Objectives: Nocturnal enuresis, the involuntary passing of urine during sleep after the age at which bladder control would normally be anticipated, is a widespread and potentially disabling disorder of children. Treatment of enuresis includes non-pharmacologic and pharmacologic procedures. Imipramine, anticholinergics, and desmopressin are appropriate drugs for treatment. Desmopressin is a synthetic analogue of vasopressin, which decreases urine output. Since efficacy and side effects of desmopressin-therapy differ in various studies, this research was conducted to evaluate the efficacy of desmopressin in enuretic children in Zanjan. Materials & Methods: In this quasi-experimental study, ۱۲۶ chidren aged ۵-۱۴ suffering from primary nocturnal enuresis, referring to pediatric nephrology clinit were entered into the study during ۲۰۰۲-۲۰۰۶. Following the written consent a questionnaire concerning the personal data and physical examination was completed for each patient. Clinical tests including U/A, U/C, Cr and serum electrolytes were carried out and after rejecting the secondary causes of enuresis ۱۰-۲۰ g intransal desmopressin was prescribed according to the age and weight of the children. The effect and complications of the drug were followed up monthly for six months. Results: Of ۱۲۶ children, ۵۶ (۴۴.۴ %) obtained full recovery, and ۴۸ (۳۸.۱%) partial recovery from nocturnal enuresis. The total recovery was ۸۲.۵ %. ۲۲ patients (۱۷.۴ %) did not respond to the drug. No significant difference was observed between age, gender, existence of stress, and effect of the drug on child enuresis. Children with familial history of nocturnal enuresis responded better to the drug. No complications were observed in patients. Conclusion: Desmopressin is an effective drug against nocturnal enuresis of children. The drug is more effective in children with familial history of primary nocturnal enuresis.

Keywords:

primary enuresis , Desmopressin (DDAVP) , Familial history of enuresis , Stress