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Desmopressin for nocturnal incontinence in the spina bifida population
M Horowitz1, A J Combs, D Gerdes
1State University of New York Health Sciences Center at Brooklyn 11203, USA.
Purpose:
We report our experience with the use of desmopressin in the spina bifida population that is dry during the day but wet at night.
Materials And Methods:
From 1994 to 1996, 18 patients with myelodysplasia were treated with desmopressin for persistent nocturnal enuresis. Initial dose was 40 mcg. before bedtime, decreased by intervals of 10 mcg. every 3 weeks. Patients were kept on the minimum dose required to keep them dry. We reviewed morning catheterized volumes, side effects and dosages needed to stay dry, and compared augmented patients with nonaugmented patients.
Results:
Of 18 patients 14 (78%) reported marked improvement in nocturnal enuresis. Of 6 augmented patients 5 (83%) are dry compared to 9 of 12 nonaugmented patients (75%). There were no adverse side effects from the use of desmopressin. Average dose to stay dry was 20 mcg. for augmented and 30 mcg. for nonaugmented patients. Of the 4 patients who had persistent nocturnal incontinence despite desmopressin 3 (75%) became dry with a single catheterization in the middle of the night.
Conclusions:
Desmopressin is successful in treating nocturnal enuresis in the spina bifida patient with diurnal continence.