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Functional bladder capacity as predictor of response to desmopressin and retention control training in
S Hamano1, T Yamanishi, T Igarashi
1Department of Urology, Chiba University Hospital, Japan.
Insights
Intranasal desmopressin (DDAVP) significantly reduced wet nights in children with nocturnal enuresis compared to retention control training (RCT). Daytime bladder capacity predicts DDAVP response, but not RCT.
Area of Science:
- Pediatrics
- Urology
- Sleep Medicine
Background:
- Monosymptomatic nocturnal enuresis (MNE) is common in childhood.
- Treatment options include pharmacotherapy and behavioral interventions.
- Predicting treatment response is crucial for effective management.
Purpose of the Study:
- To compare the efficacy of intranasal desmopressin (DDAVP) and retention control training (RCT) for childhood MNE.
- To assess the predictive value of daytime functional bladder capacity (DFBC) for both treatments.
Main Methods:
- A study involving 114 children with MNE.
- Participants were randomized to receive either intranasal DDAVP (n=54) or RCT (n=60).
- DFBC was measured at baseline and analyzed for its predictive value.
Main Results:
- DDAVP showed a significantly greater decrease in wet nights (90.0%) compared to RCT (58.3%).
- Strong improvement was observed in 38.9% of DDAVP patients versus 23.3% of RCT patients.
- DFBC predicted response to DDAVP (responders had higher DFBC) but not to RCT.
Conclusions:
- Intranasal DDAVP is more effective than RCT in reducing wet nights for childhood MNE.
- DFBC is a valuable predictor for DDAVP treatment success.
- RCT efficacy is not predicted by DFBC.
Objective:
To evaluate the efficacy of intranasal desmopressin (DDAVP) and retention control training (RCT) for monosymptomatic nocturnal enuresis in childhood and to assess the predictive value of daytime functional bladder capacity for both methods.
Materials And Methods:
A total of 114 children with monosymptomatic nocturnal enuresis, of whom 99 (86.8%) wetted the bed every night, were treated with 1 of the 2 methods: intranasal DDAVP in 54 and RCT in 60 subjects.
Results:
Twenty-one of 54 patients (38.9%) and 14 of 60 patients (23.3%) in the DDAVP group and the RCT group, respectively, achieved strong improvement (p = 0.061). Forty-five of 54 (90.0%) in the DDAVP and 35 of 60 (58.3%) in the RCT group had a more than 50% decrease in wet nights (p = 0.004). In the DDAVP group, the functional bladder capacities at baseline in responders and nonresponders were 82+/-22% and 56+/-20% of the predicted bladder capacity for their age (p<0.001). In the RCT group, responders and nonresponders did not differ in functional bladder capacity at baseline.
Conclusion:
DDAVP treatment is more effective than RCT in decreasing the number of wet nights in childhood nocturnal enuresis, but not so effective in children with a low functional bladder capacity. Daytime functional bladder capacity is a valuable predictor of response to DDAVP, but not so to RCT.
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