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The use of desmopressin in the management of nocturnal enuresis in patients with spinal cord injury.
Eura Medicophys. 2007 Sep; 43(3):333-8.EM

Abstract

AIM

The aim of this study is to evaluate the use of desmopressin acetate (DDAVP) in the management of nocturnal enuresis in patients with spinal cord injury (SCI), as well as arginine vasopressin (AVP) daily production, urine output, urine osmolarity and clean intermittent catheterization (CIC) before and after the use of desmopressin.

METHODS

We studied 11 patients with SCI (7 men 4 women). All patients attended a rehabilitation program and used a wheelchair for locomotion. To improve bladder function and achieve socially acceptable continence all patients were placed on a regimen of anticholinergic drugs (oxybutynin 5 mg, 1x3 daily), evening antibiotic prophylaxis and CIC. The subjects were also on night CIC in order to avoid nocturnal incontinence. DDAVP was given intranasally (20 mg before bedtime) in association with other standard therapy. Urine samples were collected under sterile conditions from all patients at 6:00 a.m. and 6:00 p.m. Urine volume was measured and the amount of urine per hour was calculated. Blood samples were also taken to measure serum AVP, urea, creatinine and serum electrolyte.

RESULTS

Our data suggest that nocturnal polyuria in SCI patients occurs due to a lack of diurnal variation of antidiuretic hormone (ADH) secretion. The use of desmopressin produced a statistically significant increase in urine production rate during the day (56.2 vs 81.2 mL/h, P<0.001) and a decrease in nocturnal urine production (59.2 vs 27.7 mL/h, P<0.001). Desmopressin treatment reflects also on urine osmolarity, which did not change during the day (496 vs 489 mOsm/mL, P>0.5) but showed a significant increase during the night (385 vs 862 mOsm/mL, P<0.001). There was a significant decrease in night CIC. No serious adverse effects were observed.

CONCLUSION

Our results suggest that desmopressin administration is an beneficial treating option for patients with SCI when fluid restriction and other preventive measures are not able to control abnormal nocturnal polyuria.

Authors+Show Affiliations

Urology Department, Elpis Hospital, Volos, Greece. zahariou@otenet.grNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

17021585

Citation

Zahariou, A, et al. "The Use of Desmopressin in the Management of Nocturnal Enuresis in Patients With Spinal Cord Injury." Europa Medicophysica, vol. 43, no. 3, 2007, pp. 333-8.
Zahariou A, Karagiannis G, Papaioannou P, et al. The use of desmopressin in the management of nocturnal enuresis in patients with spinal cord injury. Eura Medicophys. 2007;43(3):333-8.
Zahariou, A., Karagiannis, G., Papaioannou, P., Stathi, K., & Michail, X. (2007). The use of desmopressin in the management of nocturnal enuresis in patients with spinal cord injury. Europa Medicophysica, 43(3), 333-8.
Zahariou A, et al. The Use of Desmopressin in the Management of Nocturnal Enuresis in Patients With Spinal Cord Injury. Eura Medicophys. 2007;43(3):333-8. PubMed PMID: 17021585.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The use of desmopressin in the management of nocturnal enuresis in patients with spinal cord injury. AU - Zahariou,A, AU - Karagiannis,G, AU - Papaioannou,P, AU - Stathi,K, AU - Michail,X, Y1 - 2006/10/03/ PY - 2006/10/6/pubmed PY - 2008/2/6/medline PY - 2006/10/6/entrez SP - 333 EP - 8 JF - Europa medicophysica JO - Eura Medicophys VL - 43 IS - 3 N2 - AIM: The aim of this study is to evaluate the use of desmopressin acetate (DDAVP) in the management of nocturnal enuresis in patients with spinal cord injury (SCI), as well as arginine vasopressin (AVP) daily production, urine output, urine osmolarity and clean intermittent catheterization (CIC) before and after the use of desmopressin. METHODS: We studied 11 patients with SCI (7 men 4 women). All patients attended a rehabilitation program and used a wheelchair for locomotion. To improve bladder function and achieve socially acceptable continence all patients were placed on a regimen of anticholinergic drugs (oxybutynin 5 mg, 1x3 daily), evening antibiotic prophylaxis and CIC. The subjects were also on night CIC in order to avoid nocturnal incontinence. DDAVP was given intranasally (20 mg before bedtime) in association with other standard therapy. Urine samples were collected under sterile conditions from all patients at 6:00 a.m. and 6:00 p.m. Urine volume was measured and the amount of urine per hour was calculated. Blood samples were also taken to measure serum AVP, urea, creatinine and serum electrolyte. RESULTS: Our data suggest that nocturnal polyuria in SCI patients occurs due to a lack of diurnal variation of antidiuretic hormone (ADH) secretion. The use of desmopressin produced a statistically significant increase in urine production rate during the day (56.2 vs 81.2 mL/h, P<0.001) and a decrease in nocturnal urine production (59.2 vs 27.7 mL/h, P<0.001). Desmopressin treatment reflects also on urine osmolarity, which did not change during the day (496 vs 489 mOsm/mL, P>0.5) but showed a significant increase during the night (385 vs 862 mOsm/mL, P<0.001). There was a significant decrease in night CIC. No serious adverse effects were observed. CONCLUSION: Our results suggest that desmopressin administration is an beneficial treating option for patients with SCI when fluid restriction and other preventive measures are not able to control abnormal nocturnal polyuria. SN - 0014-2573 UR - https://www.unboundmedicine.com/medline/citation/17021585/The_use_of_desmopressin_in_the_management_of_nocturnal_enuresis_in_patients_with_spinal_cord_injury_ L2 - http://www.minervamedica.it/index2.t?show=R33Y2007N03A0333 DB - PRIME DP - Unbound Medicine ER -