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Comparison of long-term efficacy of desmopressin lyophilisate and enuretic alarm for monosymptomatic enuresis and assessment of predictive factors for success: a randomized prospective trial.
J Urol. 2015 Feb; 193(2):655-61.JU

Abstract

PURPOSE

We compared the long-term success of desmopressin sublingual lyophilisate formulation and enuretic alarm therapy in children with primary monosymptomatic nocturnal enuresis, and determined predictive factors for treatment success.

MATERIALS AND METHODS

A total of 142 children with primary monosymptomatic nocturnal enuresis were randomized to receive treatment consisting of desmopressin or enuretic alarm for 6 months. Treatment compliance and response were reviewed monthly in each patient using a 30-day bed-wetting diary. Outcomes were assessed according to International Children's Continence Society criteria, and success rates at 6 and 12 months were compared for desmopressin and enuretic alarm. Additional intention to treat analyses were performed, considering cases with missing data as failures. Possible demographic factors predicting success were investigated by logistic regression analysis.

RESULTS

Overall 4 children (5.2%) in the desmopressin group and 20 (30.7%) in the enuretic alarm group withdrew after randomization. Based on patients who completed 6 months of treatment, success (more than 90% reduction in wet nights per month) was achieved in 76.8% and 61.8% of children in the desmopressin and enuretic alarm groups, respectively. At 12 months 77.8% of those receiving desmopressin and 75% of those treated with enuretic alarm had success. However, long-term success rate was significantly higher with desmopressin (68.8% vs 46.2%) if intention to treat population was considered. Multivariate analysis revealed treatment group, severity of enuresis and monthly income as independent predictors of cure at 6 months.

CONCLUSIONS

In compliant patients desmopressin lyophilisate and enuretic alarm provided equivalent success at the end of treatment and after extended followup. Alarm therapy had a high rate of early withdrawal from therapy and consequently lower rates of success on intention to treat analyses. Severe enuresis (more than 5 wet nights weekly) is an important predictive factor for cure after first-line treatment.

Authors+Show Affiliations

Urology Clinic, Ümraniye Training and Research Hospital, Istanbul, Turkey; Urology Clinic, Haydarpasa Training and Research Hospital (CK), Istanbul, Turkey. Electronic address: ffonol@yahoo.com.Urology Clinic, Ümraniye Training and Research Hospital, Istanbul, Turkey; Urology Clinic, Haydarpasa Training and Research Hospital (CK), Istanbul, Turkey.Urology Clinic, Ümraniye Training and Research Hospital, Istanbul, Turkey; Urology Clinic, Haydarpasa Training and Research Hospital (CK), Istanbul, Turkey.Urology Clinic, Ümraniye Training and Research Hospital, Istanbul, Turkey; Urology Clinic, Haydarpasa Training and Research Hospital (CK), Istanbul, Turkey.Urology Clinic, Ümraniye Training and Research Hospital, Istanbul, Turkey; Urology Clinic, Haydarpasa Training and Research Hospital (CK), Istanbul, Turkey.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

25158273

Citation

Önol, Fikret Fatih, et al. "Comparison of Long-term Efficacy of Desmopressin Lyophilisate and Enuretic Alarm for Monosymptomatic Enuresis and Assessment of Predictive Factors for Success: a Randomized Prospective Trial." The Journal of Urology, vol. 193, no. 2, 2015, pp. 655-61.
Önol FF, Guzel R, Tahra A, et al. Comparison of long-term efficacy of desmopressin lyophilisate and enuretic alarm for monosymptomatic enuresis and assessment of predictive factors for success: a randomized prospective trial. J Urol. 2015;193(2):655-61.
Önol, F. F., Guzel, R., Tahra, A., Kaya, C., & Boylu, U. (2015). Comparison of long-term efficacy of desmopressin lyophilisate and enuretic alarm for monosymptomatic enuresis and assessment of predictive factors for success: a randomized prospective trial. The Journal of Urology, 193(2), 655-61. https://doi.org/10.1016/j.juro.2014.08.088
Önol FF, et al. Comparison of Long-term Efficacy of Desmopressin Lyophilisate and Enuretic Alarm for Monosymptomatic Enuresis and Assessment of Predictive Factors for Success: a Randomized Prospective Trial. J Urol. 2015;193(2):655-61. PubMed PMID: 25158273.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of long-term efficacy of desmopressin lyophilisate and enuretic alarm for monosymptomatic enuresis and assessment of predictive factors for success: a randomized prospective trial. AU - Önol,Fikret Fatih, AU - Guzel,Rasim, AU - Tahra,Ahmet, AU - Kaya,Cevdet, AU - Boylu,Ugur, Y1 - 2014/08/23/ PY - 2014/08/13/accepted PY - 2014/8/27/entrez PY - 2014/8/27/pubmed PY - 2015/10/8/medline KW - clinical alarms KW - comparative study KW - deamino arginine vasopressin KW - nocturnal enuresis SP - 655 EP - 61 JF - The Journal of urology JO - J Urol VL - 193 IS - 2 N2 - PURPOSE: We compared the long-term success of desmopressin sublingual lyophilisate formulation and enuretic alarm therapy in children with primary monosymptomatic nocturnal enuresis, and determined predictive factors for treatment success. MATERIALS AND METHODS: A total of 142 children with primary monosymptomatic nocturnal enuresis were randomized to receive treatment consisting of desmopressin or enuretic alarm for 6 months. Treatment compliance and response were reviewed monthly in each patient using a 30-day bed-wetting diary. Outcomes were assessed according to International Children's Continence Society criteria, and success rates at 6 and 12 months were compared for desmopressin and enuretic alarm. Additional intention to treat analyses were performed, considering cases with missing data as failures. Possible demographic factors predicting success were investigated by logistic regression analysis. RESULTS: Overall 4 children (5.2%) in the desmopressin group and 20 (30.7%) in the enuretic alarm group withdrew after randomization. Based on patients who completed 6 months of treatment, success (more than 90% reduction in wet nights per month) was achieved in 76.8% and 61.8% of children in the desmopressin and enuretic alarm groups, respectively. At 12 months 77.8% of those receiving desmopressin and 75% of those treated with enuretic alarm had success. However, long-term success rate was significantly higher with desmopressin (68.8% vs 46.2%) if intention to treat population was considered. Multivariate analysis revealed treatment group, severity of enuresis and monthly income as independent predictors of cure at 6 months. CONCLUSIONS: In compliant patients desmopressin lyophilisate and enuretic alarm provided equivalent success at the end of treatment and after extended followup. Alarm therapy had a high rate of early withdrawal from therapy and consequently lower rates of success on intention to treat analyses. Severe enuresis (more than 5 wet nights weekly) is an important predictive factor for cure after first-line treatment. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/25158273/Comparison_of_long_term_efficacy_of_desmopressin_lyophilisate_and_enuretic_alarm_for_monosymptomatic_enuresis_and_assessment_of_predictive_factors_for_success:_a_randomized_prospective_trial_ L2 - https://www.jurology.com/doi/10.1016/j.juro.2014.08.088?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -