Low compliance contribute to insufficient Desmopressin response of primary monosymptomatic nocturnal enuresis and the role of voiding school

Zoran Radojicic,Ognjen Radojicic,Darko Laketic,Sasa Milivojevic,Jelena Milin Lazovic,Irena Koricanac,Natasa Milic

doi:10.1186/s12887-021-02714-z

Zoran Radojicic, Ognjen Radojicic + Show 5 more

Open Access

https://doi.org/10.1186/s12887-021-02714-z

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Abstract

AimsTo evaluate the impact of compliance on the therapeutic effects of Desmopressin, as well as the importance of establishing the voiding school for low-compliance children in primary monosymptomatic enuresis treatment.MethodsEighty-nine patients with primary monosymptomatic enuresis treated with Desmopressin were observed during the 2017–2020 at University Children’s Hospital Belgrade, Serbia. The average patients age was 7.7 ± 2.4 years; 65 (73%) were boys and 24 (27%) % were girls. After the 3 months of Desmopressin treatment, the effect of therapy was evaluated according to the compliance. After the treatment, low-compliance patients and their parents were suggested to visit a voiding school.ResultsA significant decrease in the median enuresis frequency was noticed during the Desmopressin treatment (25.0 (20.0–26.0) vs 10.0 (2.0–17.0) per month, before vs after treatment, respectively) (p < 0.001). Patients with low compliance had a poorer response to Desmopressin (p < 0.001). An median enuresis reduction in the good compliance group was 92.3% (86.7 -95%), while in the low compliance group was 28.6% (16.7–43.3%). After attending voiding school, there was a significant increase in compliance (p < 0.001), associated with an median percent decrease in enuresis of 84.0% (75.0–95.5%) (p < 0.001).ConclusionCompliance considerably influences the beneficial effects of Desmopressin. Patients with poor therapeutic effects should be evaluated for compliance and introduced to voiding school.

Highlights

Monosymptomatic nocturnal enuresis (MNE) is intermittent, uncontrolled sleep-time bedwetting without any signs or symptoms of lower urinary tract dysfunction in child after the age of five [1]
In addition to overall compliance, adherence to each separate drug intake or conservative measure instruction was analyzed in terms of nocturnal enuresis change (Table 2) and significant differences in the therapeutic effects of Desmopressin were noticed with respect to adherence to each separate measure
A significant increase in compliance was reported among 31 patients in low compliance group who attended voiding school (p < 0.001) (Fig. 2)

Summary

Methods

Eighty-nine patients with primary monosymptomatic enuresis treated with Desmopressin were observed during the 2017–2020 at University Children’s Hospital Belgrade, Serbia. The average patients age was 7.7 ± 2.4 years; 65 (73%) were boys and 24 (27%) % were girls. After the 3 months of Desmopressin treatment, the effect of therapy was evaluated according to the compliance. Low-compliance patients and their parents were suggested to visit a voiding school

Results

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