Prospective evaluation of factors affecting the response and relapse rates to desmopressin therapy in male monosymptomatic enuretic adults.

OBJECTIVES

To investigate the factors affecting desmopressin response and relapse rates in an adult male population with monosymptomatic nocturnal enuresis (MNE). Nocturnal enuresis is a frequent heterogeneous condition, which is genetically complex in nature.

METHODS

Between September 2007 and January 2009, a total of 143 male soldiers with nocturnal enuresis admitted to a military referral center. Eighty-six male soldiers with MNE were investigated. Family history, smoking habits, previous treatment history, coexisting urinary symptoms, bowel habits, maximal functional bladder capacity, and body mass index were examined to determine their effects on desmopressin response. All patients initially received 0.2 mg of desmopressin. Patients were evaluated after 2 weeks and non-full responders were switched to 0.4-mg desmopressin, with total treatment duration of 3 months. The mean follow-up after starting the initial dose was 9.4 months (4.5-15 months).

RESULTS

Of the 86 patients with MNE, 37 patients (43%) showed full response. None of the investigated parameters were shown to affect response rates. With regard to the relapse rates, 36.1% of the patients were taking 0.2-mg tablets and 63.9% were taking 0.4-mg tablets. This difference was statistically significant (P <.05). Other parameters did not have any significant effect on relapse rates.

CONCLUSIONS

Adult male MNE is a heterogeneous condition and desmopressin appears to be an effective and well-tolerated treatment. Higher response rate can be predicted if the nocturnal urine output exceeds functional bladder capacity for each individual. Our study also contributed that relapse rates depend on initial tailored dose; however, this needs to be confirmed with further studies.