Desmopressin alone versus desmopressin and an anticholinergic in the first-line treatment of primary monosymptomatic nocturnal enuresis: a multicenter study.

Abstract

BACKGROUND: The aim of this study was to compare the efficacy of combination

therapy with desmopressin and an anticholinergic to desmopressin monotherapy for

the first-line treatment of children with primary monosymptomatic nocturnal

enuresis (PMNE). METHODS: A total of 98 children with PMNE (male:female 71:27)

aged 5-16 (mean age 7.18 +/- 1.8) years were retrospectively analyzed. The

patients were divided into two groups: the monotherapy group (n = 49) was given

oral desmopressin alone, and the combination therapy group (n = 49) was given

desmopressin plus an anticholinergic (propiverine 10 mg) as a first-line

treatment. The two groups were matched according to the following criteria: age,

gender, and baseline frequency of nocturnal enuresis. The efficacy was evaluated

by International Children's Continence Society criteria at 1 and 3 months after

treatment initiation. RESULTS: The combination therapy group showed a higher rate

of complete response than the monotherapy group (20.4 vs. 6.1% at 1 month of

treatment; 46.9 vs. 22.4% at 3 months of treatment). In terms of success

(response and complete response), there was a significant difference between the

two groups after 3 months of treatment (P = 0.002). CONCLUSIONS: Our results

indicate that combination therapy with desmopressin plus an anticholinergic is

quicker and more effective than desmopressin monotherapy in reducing PMNE.