Subtypes in monosymptomatic nocturnal enuresis II

Lasting cure rates in monosymptomatic nocturnal enuresis (MNE), using the a larm, imipramine or desmopressin, have been quoted as 43%, 17% and 22%, res pectively. The low cure rates in addition to the number of different treatm ents indicate insufficient knowledge of MNE. Only research on arginine vaso pressin (AVP) levels and nocturnal enuresis is unique in attempting to find a group within the MNE population that could benefit from substitution the rapy with desmopressin. AVP levels are restored or amplified during desmopr essin treatment. However, low nocturnal BVP production with high nocturnal urine output may be indicative of a disturbance in circadian rhythm. Pre-cl inical data suggest a role for melatonin in the regulation of endogenous AV P and in the regulation of the sleep/wake cycle.