Related Experiment Video
Updated: Jan 3, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Does smoking exposure affect response to treatment in children with primary monosymptomatic nocturnal enuresis?
Gülşah Kaya Aksoy1, Nevin Semerci Koyun1, Çağla Serpil Doğan1
1University of Health Sciences, Antalya Training and Research Hospital, Turkey.
Insights
Cigarette smoke exposure significantly reduces desmopressin treatment success in children with primary monosymptomatic nocturnal enuresis (PMNE). This modifiable risk factor impacts treatment outcomes, highlighting the need for smoke-free environments.
Area of Science:
- Pediatric Nephrology
- Environmental Health
- Clinical Pharmacology
Background:
- Primary monosymptomatic nocturnal enuresis (PMNE) affects numerous children, with treatment success influenced by various factors.
- The impact of environmental exposures, such as cigarette smoke, on PMNE treatment efficacy remains an area of investigation.
Purpose of the Study:
- To investigate the association between passive cigarette smoke exposure and treatment response to desmopressin in children diagnosed with PMNE.
- To identify other potential risk factors contributing to desmopressin treatment failure in this pediatric population.
Main Methods:
- Retrospective review of medical records for pediatric patients with moderate to severe PMNE treated with desmopressin.
- Evaluation of treatment response (complete, partial, failure) after 3 months of therapy.
- Statistical analysis to determine the relationship between cigarette smoke exposure and treatment outcomes, controlling for other variables.
Main Results:
- Passive smoke exposure was present in 53.1% of the 81 included children.
- Treatment failure rates were significantly higher in children exposed to cigarette smoke (55.8%) compared to non-exposed children (26.4%) (p=0.001).
- Cigarette smoke exposure emerged as the sole independent risk factor for desmopressin treatment failure (OR=3.214, p=0.024).
Conclusions:
- Passive cigarette smoke exposure is a significant and modifiable risk factor that diminishes the effectiveness of desmopressin treatment for PMNE in children.
- Reducing environmental smoke exposure may improve treatment outcomes for children with nocturnal enuresis.
- Further research into environmental influences on pediatric enuresis treatment is warranted.
Background:
There are many variables affecting the success of treatment in children with primary monosymptomatic nocturnal enuresis (PMNE). This study investigates the possible effect of cigarette smoke exposure on desmopressin treatment response in children with PMNE.
Method:
The medical records of pediatric patients with PMNE between February 2018 and December 2018 were retrospectively reviewed. Those who had moderate (3-5 wet nights/week) and severe (>5 wet nights/week) PMNE were included in the study. All patients received 120 mcg of sublingual desmopressin. After 3 months of therapy, treatment response was classified as complete response (100% dry night), partial response (between 50% and 99%) and non-responsiveness (<49% improvement). Partial response or non-responsiveness is considered as treatment failure. The relationship between treatment response to desmopressin and exposure to cigarette smoke was evaluated. Moreover, the other risk factors for treatment failure were investigated.
Results:
A total of 81 children with the diagnosis of PMNE, with a mean age of 9.98 ± 2.62 years, were included in the study. The frequency of passive smoke exposure at home was 53.1%. Sixty-two patients (76.5%) had severe PMNE, and the response to desmopressin decreased with severity of symptoms. Non-responsiveness to treatment, partial response, and complete response were observed in 11 (13.6%), 23 (28.4%), and 47 (58.0%) of patients, respectively. Treatment failure (n = 34, 42%) was 55.8% in children exposed to smoke and 26.4% in those who were not (p = 0.001). Although univariate analysis revealed that the severity of symptoms and smoke exposure were associated with treatment failure, in multivariate analysis, the presence of smoke exposure was the only independent risk factor (OR = 3.214, 95% CI: 0.125-0.888; p = 0.024) (Summary Table 1).
Conclusion:
Exposure to cigarette smoke is a changeable and important risk factor that reduces the success of desmopressin treatment in children with PMNE.
Related Concept Videos
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:24Substance Use Disorders Affecting Sleep
Understanding the concepts of physical dependence,...
01:30Attention-Deficit/Hyperactivity Disorder
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings....
01:26The Micturition Reflex
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating...
01:23Drugs Acting on Autonomic Ganglia: Stimulants
Ganglionic stimulants activate NM nicotinic receptors in autonomic ganglia, falling into two categories: nicotine mimetics [e.g., lobeline, dimethylpiperazine, tetramethylammonium] and muscarinic receptor agonists [e.g., muscarine, methacholine]. The first category's action is rapid and blocked by nicotinic receptor antagonists, while the second category's action is delayed and blocked by atropine-like agents. Nicotine, an alkaloid, affects the heart rate by stimulating...
01:17Urinary Tract Infection IV: Nursing Management