Related Experiment Videos
The relationship between desmopressin treatment and voiding pattern in children
G M Hvistendahl1, Y F Rawashdeh, K Kamperis
1International Enuresis Research Center, Institute of Experimental Clinical Research, Skejby Hospital, Aarhus, Denmark.
Insights
Desmopressin treatment reduced 24-hour urine production in children with nocturnal enuresis but did not change bladder capacity. Many enuretics had smaller functional bladder capacity than expected for their age.
Area of Science:
- Pediatric Nephrology
- Urology
- Clinical Pharmacology
Background:
- Monosymptomatic nocturnal enuresis affects many children, impacting quality of life.
- Understanding voiding patterns and bladder capacity is crucial for effective treatment.
- Desmopressin is a common treatment for nocturnal enuresis, primarily acting on urine production.
Purpose of the Study:
- To evaluate the effect of short-term desmopressin treatment on voiding patterns.
- To assess changes in functional and mean bladder capacity during desmopressin therapy.
- To correlate bladder capacity with treatment response in children with nocturnal enuresis.
Main Methods:
- A study involving 120 children (6-16 years) with monosymptomatic nocturnal enuresis.
- Baseline and desmopressin treatment periods of 2 weeks each, with home monitoring of fluid intake and diuresis.
- Detailed recording of voiding times and volumes, with calculation of functional bladder capacity, mean bladder capacity, and 24-hour diuresis.
Main Results:
- Desmopressin significantly reduced mean 24-hour urine production.
- Functional and mean bladder capacities remained unaffected by desmopressin treatment.
- Non-responders had smaller bladder capacities than responders; most children had age-inadequate functional bladder capacity.
Conclusions:
- Short-term desmopressin effectively reduces 24-hour urine production in enuretic children.
- Desmopressin does not alter functional or mean bladder capacity.
- Reduced functional bladder capacity is common in children with nocturnal enuresis, irrespective of desmopressin response.
Objective:
To collect data on voiding patterns at baseline (no treatment) and during short-term desmopressin treatment, with special reference to the functional and the mean bladder capacity.
Patients And Methods:
The study included 120 children (aged 6-16 years) with monosymptomatic nocturnal enuresis. While at home they recorded their fluid intake and diuresis in two separate periods, i.e. 2 weeks as a baseline registration and another 2 weeks during desmopressin titration. On four study days the children recorded the time and volume of all voids and of fluid intake. From the diaries their functional and mean bladder capacities, 24-h diuresis and day/night ratio of diuresis were determined.
Results:
The mean 24-h diuresis was significantly lower during short-term desmopressin treatment. In most of the enuretics the mean day/night ratio increased on desmopressin treatment. The mean functional and mean bladder capacities were unaffected by desmopressin. Those not responding had bladder capacities of approximately 100 mL less than full responders. Regardless of response, practically all the enuretics in the study had a smaller functional bladder capacity than expected for their age. Among responders the morning void was significantly larger than the following voids during the day, and among non-responders the fourth void was significantly larger than the previous voids in the day. Desmopressin treatment did not influence these volumes significantly.
Conclusions:
Short-term desmopressin treatment does not affect functional and mean bladder capacity; 24-h urine production was reduced significantly (P<0.01) during desmopressin treatment.