PURPOSE Several monocentre authors described an improvement in outcome of desmopressin treatment when not terminated abruptly but instead tapered out. This national multicentre retrospective survey was designed to test whether structured withdrawal of desmopressin can improve outcome. MATERIAL AND METHODS 487 enuretic patients from 181 centres were enrolled. The study was conducted on out-patients with typical age and gender distribution. 267 patients were pre-treated. At outset, 41% showed 7 wet nights/week, 45% showed 3-6 and 14% <3. All patients were treated with desmopressin. Response to therapy was subdivided into response (wet nights reduction >90%), partial response (50-90%) and minor reduction (<50%). After 4-26 weeks treatment was either abruptly terminated or tapered. Relief of bedwetting was defined as <2 wet nights/month. RESULTS The group with abrupt termination (173 children) showed 51% response, 27% partial response and 22% minor reduction. The tapering group (314 children) had 72% response, 24% partial response and 4% minor reduction (p<0.0001). Enuresis frequency with abrupt termination decreased from 20.53 wet nights/month before treatment to 5.8. The tapering group had 21 wet nights/months before and 1.86 after (p<0.0001). One month follow up showed <2 wet nights/month in 57% with abrupt termination and in 80% with tapering (p<0.0001). Pre-treatment had no influence. No severe side effects occurred. CONCLUSIONS This national multicentre retrospective analysis proves that antidiuretic treatment followed by a structured withdrawal program is superior to regular treatment in enuretic children and therefore should be the mainstay of treatment. It is also superior to published outcomes of alarm treatment.