DESMOPRESSIN FOR NOCTURNAL INCONTINENCE IN THE SPINA-BIFIDA POPULATION

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. M aterials and Methods: From 1994 to 1996, 18 patients with myelodysplas ia were treated with desmopressin for persistent nocturnal enuresis. I nitial dose was 40 mcg. before bedtime, decreased by intervals of 10 m cg. 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 n onaugmented patients. Results: Of 18 patients 14 (78%) reported marked improvement in nocturnal enuresis. Of 6 augmented patients 5 (83%) ar e dry compared to 9 of 12 nonaugmented patients (75%). There were no a dverse 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 de smopressin 3 (75%) became dry with a single catheterization in the mid dle of the night. Conclusions: Desmopressin is successful in treating nocturnal enuresis in the spina bifida patient with diurnal continence .