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Evidence summaries

Desmopressin for Nocturnal Enuresis in Children

Desmopressin is effective for nocturnal enuresis, but alarms may have better long-term effects. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 47 studies with a total of 3 448 subjects. Desmopressin was effective in reducing bed-wetting during treatment, compared with placebo (e.g. 20 µg: 1.34 fewer wet nights per week; 95% confidence interval (CI) 1.11 to 1.57), and children were more likely to become dry (e.g. 118/146, 81% versus 140/142, 98% still wet; relative risk (RR) for failure to achieve 14 dry nights with 20 µg was 0.84; 95% CI 0.79 to 0.91). However, there was no difference between the two patient groups after treatment was finished. There was no clear dose-related effect of desmopressin, but the evidence was limited. Data which compared oral and nasal administration were too few to be conclusive. In four small trials, there were no significant differences between desmopressin and alarms during treatment when these were used separately, but the chance of failure or relapse after treatment stopped was lower after an alarm in two small trials (40/62, 65% versus 26/57, 46%; RR 1.42, 95% CI 1.05 to 1.91).

References

Primary/Secondary Keywords