Clinical study of intermediate-long term therapy with desmopressin acetate for primary monosymptomatic nocturnal enuresis in children

doi:10.19538/j.ek2017110614

Abstract：Objective To explore the effect of intermediate-long term therapy with desmopressin acetate (DA) in treating children with enuresis.Methods Totally 320 PMNE children treated with DA aged 5-15 years from November 2013 to March 2016 were included.The cases who stopped wetting bed for 2 months within 3-6 months of treatment were observed.According to convenience sampling method,the observed patients were divided into gradually withdraw (GW) group and immediate withdraw(DW) group.GW group use taper therapy and DA was gradually withdrawn within 9 months.In DW group DA was withdrawn immediately.The relapse cases were recorded 1 month after discontinuation of DA in the two groups.Compare the relapse and severity of enuresis.Results Response of DA:full response (FR) in 224 cases (70.1％),partial response (PR) in 73 cases (23.0％) and no response (NR) in 23 cases (6.9％).Totally 133 cases(continuously 2 months of dry bed) were up to withdrawal criteria in 3-6 months.Totally 26 cases were lost follow-up and 107 cases were observed,63 cases were included in GW group and 36 cases had DA withdrawal within 9 months;44 cases were included in DW group.The relapse cases were 37 cases (84.1％) in DW group,and GW group,8 cases (22.2％).The relapse rate was significantly different between the two groups.No obvious adveme events were observed in 27 cases with DA treatment for 1 year.Moderate-severe enuresis cases of the recurrence ones and the cases treated for 1 year were significantly higher than those of the non-recurrent cases.Conclusion DA is a safe and effective way to treat PMNE.Gradually withdrawing the DA in intermediate-long term treatment can obviously decrease the recurrence of PMNE.The recurrence rate is higher in moderate-severe enuresis than that of mild cases.