Combination therapy for nocturnal enuresis with desmopressin and an alarm device

Abstract

The efficacy of alarm monotherapy (35 children) was compared with the efficacy of alarm treatment in combination with 40 micrograms desmopressin (Minirin, DDAVP) nasal spray (36 children). At the end of the treatment period, children receiving combination therapy had more dry nights per week (mean: 6.1) than children using an alarm alone (mean: 4.8). In addition, more children achieved an initial success (4 weeks of dryness) following combination treatment (27 children [75%]) compared with alarm monotherapy (16 children [46%], P < 0.005). This improvement with alarm plus desmopressin was particularly pronounced in children with severe wetting (> or = 6 nights per week), family problems or behavioural problems. It may, therefore, be appropriate to manage children in these categories with an enuresis alarm supplemented with desmopressin to improve treatment outcome.