Related Experiment Video
Updated: Jun 15, 2025
Author Spotlight: Advancing Varicocele Treatment with Neuromuscular Electrical Stimulation
Published on: August 30, 2024
Parasacral Transcutaneous Electrical Nerve Stimulation with Desmopressin Acetate for Treating Primary Monosymptomatic
Melissa Faria Dutra1, Eleonora Moreira Lima1, José Bastos Murillo2,3
1Departamento de Pediatria Unidade de Nefrologia Pediátrica, Faculdade de Medicina, Hospital das Clínicas, Universidade Federal de Minas Gerais - UFMG, Belo Horizonte, MG, Brasil.
Insights
Combining desmopressin acetate with parasacral transcutaneous electrical nerve stimulation (PTENS) effectively treats primary monosymptomatic enuresis (PMNE) in children and adolescents. This combination therapy significantly reduced wet nights short-term and maintained improvements six months post-treatment.
Area of Science:
- Pediatric Urology
- Nephrology
- Neurology
Background:
- Primary monosymptomatic enuresis (PMNE) affects a significant number of children.
- Approximately one-third of children with PMNE do not respond to initial treatments.
- Refractory enuresis necessitates exploring alternative therapeutic strategies.
Purpose of the Study:
- To evaluate the effectiveness of combining desmopressin acetate with parasacral transcutaneous electrical nerve stimulation (PTENS).
- To assess both short-term and six-month outcomes in children and adolescents with PMNE.
- To determine if this combination therapy offers sustained benefits for non-responders to first-line treatments.
Main Methods:
- A randomized controlled trial involving children and adolescents aged 6-17 years with PMNE.
- Participants received either desmopressin acetate with active PTENS or desmopressin acetate with sham PTENS.
- Weekly 30-minute electrotherapy sessions were conducted for 15 weeks, with outcomes assessed using a wet night calendar.
Main Results:
- Both treatment groups showed a significant reduction in wet nights post-intervention (p < 0.001).
- The intervention group (active PTENS) demonstrated significant improvements immediately after treatment (p=0.005) and at six months (p< 0.001) compared to the placebo group.
- Kaplan-Meier analysis indicated progressively greater improvement in the intervention group from week 15 onwards (log-rank test, p < 0.01).
Conclusions:
- A 15-week course of desmopressin acetate combined with PTENS is effective in reducing wet nights in pediatric PMNE.
- The therapeutic benefits of this combined approach are sustained for at least six months after treatment cessation.
- This combination therapy represents a promising treatment option for children and adolescents with refractory PMNE.
Purpose:
Approximately one-third of the children with primary monosymptomatic enuresis (PMNE) do not respond to first-line treatment. We aimed to investigate the short-term and six-month effectiveness of combining desmopressin acetate with parasacral transcutaneous electrical nerve stimulation (PTENS) in these children and adolescents.
Materials And Methods:
Participants aged six-17 years with PMNE were randomly assigned to receive desmopressin acetate with active or sham PTENS. Both groups participated in weekly 30-minute electrotherapy sessions for 15 weeks. The intervention group (IG) received electrotherapy at a frequency of 10 Hz and pulse width of 700 µs. A dry and wet nights calendar assessed the frequency of wet nights in the short term and six months after the intervention ended.
Results:
Of 66 participants, 34 were randomized to the IG. The median age was 10.3 years (8.8 - 12), and 53% were male. Intention-to-treat analysis showed a significant reduction in the frequency of wet nights after the interventions (p < 0.001) in both groups, with the IG demonstrating significant improvement, immediately after the interventions (p=0.005) and after six months (p< 0.001) compared to the placebo group (PG). The Kaplan-Meier survival analysis showed improvement in the IG that became more pronounced from the 15th week onwards (log-rank test, p < 0.01). Conclusions: A 15-week treatment with desmopressin acetate and PTENS significantly reduced wet nights in children and adolescents with PMNE, and this improvement was maintained six months after the interventions.
