Efficacy of Desmopressin and Enuretic Alarm as the First and Second-Line Treatment for Monosymptomatic Nocturnal Enuresis; A Prospective, Randomized, Cross-Over Study

Abstract

Purpose To compare the efficacy of desmopressin (DESM) and enuretic alarm (EA) for the treatment of monosymptomatic nocturnal enuresis (MNE). Material and Methods Children with MNE were randomly assigned to either oral DESM or EA group. After 3 months of the treatment, result was assessed by 1-month wetting diary; full response (FR): reduction rate in the wetting episode of ≥90% or mean wetting episode of ≤ 1/month, partial response (PR): reduction rate of 50∼89%, no response (NR): reduction rate of 1/month. Children with PR or NR were switched to the alternative treatment and the result was evaluated after 3-month of the treatment. Results Of the total of 97 children (74 boys, 23 girls), 51 were assigned to DESM and 46 to EA. Mean age was 8.4±2.1 years, and mean baseline wetting episode was 5.6±1.9/week. After the first-line treatment, 39.2% of DESM and 54.3% of EA obtained FR (p=0.302). And 82.3% of DESM and 89.1% of EA achieved successful result. Of the children with FR, 33% of DESM and 12% of EA experienced relapse (p=0.095). After the second-line treatment, 55.5% of EA-DESM and 50.0% of DESM-EA obtained FR (p=0.572). And 83.3% of EA-DESM and 75.0% of DESM-EA achieved successful result. Conclusions Treatment efficacy and relapse rate were comparable between DESM and EA in the children with MNE. Switch to the alternative treatment gave an additional benefit.