Evaluation of different modes of combined therapy in children with monosymptomatic nocturnal enuresis

Authors

  • Mandy Vogt,

    1. Department of Paediatric Surgery, University of Leipzig, Leipzig, and Department of Paediatric Surgery, Johann Wolfgang-Goethe University, Frankfurt, Germany
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  • Thomas Lehnert,

    1. Department of Paediatric Surgery, University of Leipzig, Leipzig, and Department of Paediatric Surgery, Johann Wolfgang-Goethe University, Frankfurt, Germany
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  • Holger Till,

    1. Department of Paediatric Surgery, University of Leipzig, Leipzig, and Department of Paediatric Surgery, Johann Wolfgang-Goethe University, Frankfurt, Germany
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  • Udo Rolle

    Corresponding author
    1. Department of Paediatric Surgery, University of Leipzig, Leipzig, and Department of Paediatric Surgery, Johann Wolfgang-Goethe University, Frankfurt, Germany
      Udo Rolle, Department of Paediatric Surgery, Johann Wolfgang-Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.
      e-mail: udo.rolle@kgu.de
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Udo Rolle, Department of Paediatric Surgery, Johann Wolfgang-Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.
e-mail: udo.rolle@kgu.de

Abstract

Study Type – Therapy (RCT)
Level of Evidence 1b

OBJECTIVE

To evaluate the efficacy of different modes of combined therapy in children with monosymptomatic nocturnal enuresis (MNE).

PATIENTS AND METHODS

A randomized prospective study was performed to compare the order of two types of combined therapy in children with MNE. Group A was treated with primary desmopressin treatment that was combined with alarm treatment after 3 months, while group B was treated with primary alarm treatment that was combined with desmopressin after 3 months.

RESULTS

Within a period of 18 months, 43 previously untreated children fulfilled the inclusion criteria. Thirteen children achieved dryness after initial monotherapy or discontinued the study. Group A consisted of 16 children and group B of 14 children. After the standardized treatment course of 6 months, 11/16 children in group A and 11/14 children in group B became dry (<3 wet nights/month). Altogether, 22/30 (73%) children were dry after combined treatment, consisting of 12/18 boys and 10/12 girls. Of the children with a normal maximum voided volume, 79% (19/24) achieved dryness, whereas only three of six children with small maximum voided volumes became dry. In all, 13/19 (68%) children with nocturnal polyuria and nine of 11 without nocturnal polyuria became dry. Only one child relapsed (group A).

CONCLUSIONS

Combined therapy proved effective in children with MNE after 6 months, with no statistically significant differences between the two different orders of treatment.

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