Do We Really Wake Up Our Children While Treating Mono-symptomatic Nocturnal Enuresis? The Importance of "Completely Wake Up"
yasin aydogmus, urologist1, okan bas, urologist2, ummu aydogmus, pediatrician3, esra gider, pediatrician3.
1Etimesgut Military Hospital, ankara, Turkey, 2Diskapi Yildirim Beyazit Training and Research Hospital, ankara, Turkey, 3Ankara Children’s Health and Diseases Hematology and Oncology Training and Research Hospital, ankara, Turkey.
Introduction: To investigate the importance of “completely waking-up” while treating mono-symptomatic nocturnal enuresis (MNE), and its effects on treatment success.
Materials and Methods: The demographic data of patients diagnosed with MNE were recorded. The patients were enrolled into 3 groups -65 patients in group 1, 65 in group 2 and 60 in group 3- with the following recommendations to the patients and their parents.Group 1- Supportive Treatment Recommendations (STR), “Completely waking up” recommendations,Group 2- STR, Only waking up,Group 3- STR, Desmopressin melt 120 µg/daily (DESM). All patients were evaluated at 1, 3 and 6 months. The treatment responses at each time point were analyzed.
Results: Study was completed with 168 patients. No significant differences were determined between the 3 groups in respect of age, gender and frequency of enuresis. At the first follow-up, treatment success rate for the 3 groups was determined as 44.3%, 25.5%, and 70.0% respectively (p<0.001). At the 2nd follow-up examination, these rates were 49.2%, 29.8% and 83.3% (p<0.001), respectively. At the end of the 3rd month, treatment with success was terminated in all groups. Patients in Groups 1 and 2 with partial and poor response were started on DESM treatment. At the 3rd examination success rates were 91.3%, 83%, and 85% (p=0.35) in group 1, 2, and 3, respectively. Binary comparisons in each follow up examinations indicated in table 1.
Conclusions: “Completely waking up” while treating MNE improves the success of STR treatment. These recommendations could significantly decrease drug usage, and may increase the treatment response rates of DESM.
| 1st month | 3rd month | 6th month(Desmopressin) | 6th month (overall) | |||||
| n(suc,unsuc) | p | n(suc,unsuc) | p | n(suc,unsuc) | p | n(suc,unsuc) | p | |
| Group 1 vs Group 2 | 63(28,35) | <0.05 | 61(30,31) | 0.001 | 31(26,5) | 0.57 | 61(56,5) | 0.14 |
| 51(13,38) | 47(14,33) | 34(28,6) | 47(39,8) | |||||
| Group 1 vs Group 3 | 63(28,35) | <0.01 | 61(30,31) | <0.001 | 31(26,5) | 0.18 | 61(56,5) | 0.19 |
| 60(42,18) | 60(50,10) | 30(21,9) | 60(51,9) | |||||
| Group 2 vs Group 3 | 51(13,38) | <0.001 | 47(14,33) | <0.001 | 34(28,6) | 0.21 | 47(39,8) | 0.49 |
| 60(42,18) | 60(50,10) | 30(21,9) | 60(51,9) | |||||
| p:Comparison between two groups (suc,unsuc): (success, unsuccess) |
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