Primary nocturnal enuresis: a novel therapeutic strategy with higher efficacy

To introduce a new protocol for patients with primary nocturnal enuresis to increase efficacy of treatment and decrease relapse rate.

A prospective study was done on 185 children diagnosed with nocturnal enuresis between the year 2007 and 2014.

Inclusion criteria consisted of: age> 5 years, monosymptomatic enuresis or non-monosymptomatic enuresis, strict abidance by the protocol; follow up > 24 months. Exclusion criteria consisted of: secondary enuresis, poor compliance to protocol, neurogenic bladder. Participants were started on: combination therapy of desmopressin 120 microgram (MELT formula) once per day and propiverine 7.5 milligram twice per day, which were then adjusted as per their response to therapy and our designed protocol. Outcome was defined as per the International Children Continence Society (ICCS) latest definitions.

122 patients satisfied the inclusion criteria and were included in the study with a median age of 9 (range 5-19 years). The mean follow up time was 62 (range 25-114 months). Our protocol showed an overall complete success of 87% with failure and relapse of 13%. The success rate of patients needing 120 mcg desmopressin as maintenance therapy to achieve dryness was 92.7% as compared to 65% success in patients needing a higher dose of desmopressin to achieve dryness (p<0.05). Age, gender and type of primary nocturnal enuresis had no effect over success (all p>0.05).

Adopting combination therapy along with structured withdrawal as per our protocol, showed higher success rates and lower relapses in primary nocturnal enuretic children.

Urology. 2018 Sep 24 [Epub ahead of print]

Michel Jabbour, Rawad Abou Zahr, Marielle Boustany

University of Balamand, Saint George Hospital University Medical Center, Division of Urology, Beirut 1100 2807, Lebanon. Electronic address: ., University of Balamand, Saint George University Medical Center, Division of Urology, Beirut 1100 2807, Lebanon. Electronic address: ., Saint George Hospital University Medical Center, Division of Urology, Beirut 1100 2807, Lebanon. Electronic address: .

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