THE EFFECTIVENESS OF DESMOPRESSIN IN THE TREATMENT OF CHILDHOOD NOCTURNAL ENURESIS - PREDICTING RESPONSE USING PRETREATMENT VARIABLES

Objective To determine the factors that predict the effectiveness of d esmopressin in the treatment of childhood nocturnal enuresis. Patients and method Sixty-six children with monosymptomatic nocturnal enuresis were treated with intranasal or oral desmopressin for a 4-week period , starting with a standard dose of 20 mu g (0.2 mg oral) and increasin g after 2 weeks where no progress was apparent to 40 mu g (0.4 mg oral ). Before treatment a range of variables (demographic, situational, en uretic history, physiological, parental attitude and child) were recor ded. Three parameters of success acted as dependent variables, with st epwise linear regression models used to determine pretreatment predict ors of success with desmopressin. Result Each outcome variable produce d a very similar model of predictors. Success, as assessed by the most dry nights over a 14-night period, was associated with less severe en uresis before treatment, a parental belief that the child's enuresis w as unstable and higher birthweight. Conclusion From the analysis, a mo del of arginine vasopressin release is proposed and the clinical impli cations of the findings addressed.