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Randomized comparison of long-term desmopressin and alarm treatment for bedwetting.
J Pediatr Urol. 2011 Feb; 7(1):21-9.JP

Abstract

OBJECTIVE

To compare the efficacy of long-term primary nocturnal enuresis (PNE) treatment using desmopressin versus enuresis alarm.

MATERIALS AND METHODS

A 6-month randomized trial was performed with patients from 29 enuresis clinics: 251 patients ≥ 5 years in age with severe PNE (mean 5.5-5.6 wet nights/week) were randomized to desmopressin (0.2-0.4 mg daily) or alarm. Efficacy was assessed by percentage reduction in mean number of wet nights/week; patients achieving dryness, mean initial duration of sleep and compliance were evaluated. Efficacy analyses were performed using the intent-to-treat population (all patients) and excluding patients who withdrew; 12-month follow-up data were collected.

RESULTS

Data could not be evaluated for the 32% of alarm patients and 7% of desmopressin patients who withdrew early. In intent-to-treat analyses, a similar proportion of patients across groups showed a ≥ 50% reduction in wet nights/week (desmopressin: 37.5%, alarm: 32.2%) and achieved dryness (desmopressin: 32%, alarm: 37%). Compliance was higher with desmopressin: 95-98% of patients took >75% of tablets; 50-78% used alarm >75% of nights. Initial sleep duration was 1.02 h longer at the end of treatment with desmopressin (95% CI: 0.045, 1.99).

CONCLUSION

Desmopressin and alarm demonstrated comparable efficacy in the treatment of PNE. Withdrawal from the alarm group was high, indicating the importance of considering family motivation before selecting treatment, for optimal outcome.

Authors+Show Affiliations

Children's Renal & Urology Unit, Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Queens Medical Centre Campus, Nottingham NG7 2UH, UK. jonathan.evans@nuh.nhs.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial, Phase IV
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20579938

Citation

Evans, Jonathan, et al. "Randomized Comparison of Long-term Desmopressin and Alarm Treatment for Bedwetting." Journal of Pediatric Urology, vol. 7, no. 1, 2011, pp. 21-9.
Evans J, Malmsten B, Maddocks A, et al. Randomized comparison of long-term desmopressin and alarm treatment for bedwetting. J Pediatr Urol. 2011;7(1):21-9.
Evans, J., Malmsten, B., Maddocks, A., Popli, H. S., & Lottmann, H. (2011). Randomized comparison of long-term desmopressin and alarm treatment for bedwetting. Journal of Pediatric Urology, 7(1), 21-9. https://doi.org/10.1016/j.jpurol.2010.04.018
Evans J, et al. Randomized Comparison of Long-term Desmopressin and Alarm Treatment for Bedwetting. J Pediatr Urol. 2011;7(1):21-9. PubMed PMID: 20579938.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Randomized comparison of long-term desmopressin and alarm treatment for bedwetting. AU - Evans,Jonathan, AU - Malmsten,Birgitta, AU - Maddocks,Alison, AU - Popli,Harbans Singh, AU - Lottmann,Henri, AU - ,, Y1 - 2010/06/25/ PY - 2010/02/04/received PY - 2010/04/30/accepted PY - 2010/6/29/entrez PY - 2010/6/29/pubmed PY - 2011/5/4/medline SP - 21 EP - 9 JF - Journal of pediatric urology JO - J Pediatr Urol VL - 7 IS - 1 N2 - OBJECTIVE: To compare the efficacy of long-term primary nocturnal enuresis (PNE) treatment using desmopressin versus enuresis alarm. MATERIALS AND METHODS: A 6-month randomized trial was performed with patients from 29 enuresis clinics: 251 patients ≥ 5 years in age with severe PNE (mean 5.5-5.6 wet nights/week) were randomized to desmopressin (0.2-0.4 mg daily) or alarm. Efficacy was assessed by percentage reduction in mean number of wet nights/week; patients achieving dryness, mean initial duration of sleep and compliance were evaluated. Efficacy analyses were performed using the intent-to-treat population (all patients) and excluding patients who withdrew; 12-month follow-up data were collected. RESULTS: Data could not be evaluated for the 32% of alarm patients and 7% of desmopressin patients who withdrew early. In intent-to-treat analyses, a similar proportion of patients across groups showed a ≥ 50% reduction in wet nights/week (desmopressin: 37.5%, alarm: 32.2%) and achieved dryness (desmopressin: 32%, alarm: 37%). Compliance was higher with desmopressin: 95-98% of patients took >75% of tablets; 50-78% used alarm >75% of nights. Initial sleep duration was 1.02 h longer at the end of treatment with desmopressin (95% CI: 0.045, 1.99). CONCLUSION: Desmopressin and alarm demonstrated comparable efficacy in the treatment of PNE. Withdrawal from the alarm group was high, indicating the importance of considering family motivation before selecting treatment, for optimal outcome. SN - 1873-4898 UR - https://www.unboundmedicine.com/medline/citation/20579938/Randomized_comparison_of_long_term_desmopressin_and_alarm_treatment_for_bedwetting_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1477-5131(10)00355-4 DB - PRIME DP - Unbound Medicine ER -