The Rate of Relapse of Primary Monosymptomatic Nocturnal Enuresis with Desmopressin Treatment in Comparison with Combined Treatment of Desmopressin and Tolterodine in Children Aged 5 to 16 Years

Abstract

Background: In the process of treating children with primary monosymptomatic nocturnal enuresis (PMNE), the relapse of PMNE after stopping the medicine causes the child to take the medicine for a prolonged time. The purpose of this study is to compare the rate of disease relapse in two groups of PMNE treatment with a combination of desmopressin + tolterodine and desmopressin alone. Materials and Methods: One hundred twenty-three patients of both genders, suffering from nocturnal enuresis, 5-16 years old, were examined in a randomized, single-blind, single-center clinical trial. The first group was given one puff of desmopressin nasal spray and the second group was given one puff of desmopressin nasal spray + 1 mg tolterodine one hour before going to sleep. Data were analyzed using SPSS 21 software and Chi-Square and student t-test (P<0.05). Results: The positive response of the patients to the treatment in the desmopressin treatment group was 100% and the relapse rate after stopping the treatment was 47.1%. In the desmopressin + tolterodine group, 96.4% responded positively to the treatment, and relapse after stopping the treatment was observed in 34.5% of them. There was no significant difference between the two groups in terms of response rate to treatment (P=0.11) and relapse after stopping the treatment (P=0.16). Conclusion: Treatment with desmopressin and desmopressin + tolterodine was effective in reducing PMNE relapse after the initial treatment process in children. Considering that there was no statistically significant difference between the desmopressin and desmopressin + tolterodine treatment groups, there is no need to add tolterodine to the treatment regimen of nocturnal enuresis.

Keywords

• nocturnal enuresis relapse
• desmopressin
• tolterodine
• primary monosymptomatic nocturnal enuresis