Summary
Objectives
To compare the efficacy and tolerability of Solifenacin plus Desmopressin and Desmopressin
alone in the treatment of primary monosymptomatic nocturnal enuresis (PMNE).
Methods
A total of 88 children, 5-14 years old, diagnosed with PMNE were enrolled in this
randomized control trial (RCT) from June 2017 to June 2020. After informed written
consent patients were randomized to one of the two therapeutic groups. Group 1 received
one puff of desmopressin nasal spray one hour before bedtime every night. Group 2
received one pill of solifenacin 5mg plus one puff of desmopressin nasal spray one
hour before bedtime every night. All patients were evaluated after three months for
their response to treatment and drug side effects.
Results
The mean age in desmopressin alone group and solifenacin plus desmopressin group was
8.1 + 2.2 (5-14) and 7.9 +2.2 (5-14) years respectively (p-value > 0.05). In group 2, 37/44 (84.09%) patients
achieved complete response after three months of treatment in comparison to group
1 in which 27/44 (61.36%) patients showed complete response (p-value < 0.05). In group
1, 8/44 (18.18%) patients developed treatment related side effects whereas in group
2, 12/44 (27.27%) patients developed side effects (p-value > 0.05). No case of discontinuation
of treatment due to side effects was observed in any of the two groups. The recurrence
rate was also significantly lower in group 2 in comparison to group 1 (8.1% vs 33.3%,
p-value < 0.05).
Conclusion
Our study demonstrated that the combination of Solifenacin plus Desmopressin is more
effective than desmopressin monotherapy in the treatment of PMNE with an acceptable
tolerability profile.
Level Of Evidence
Level I.
Keywords
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References
- The standardization of terminology of lower urinary tract function in children and adolescents: update report from the standardization committee of the International Children's Continence Society.Neurourol Urodyn. 2016 Apr; 35: 471-481
- Management and treatment of nocturnal enuresis—an updated standardization document from the International Children's Continence Society.J Pediatr Urol. 2020 Feb 1; 16: 10-19
- Prevalence of nocturnal enuresis and related risk factors in school-age children in Egypt: an epidemiological study.World J Urol. 2017 Mar; 35: 459-465
- Prevalence of nocturnal enuresis and its influence on quality of life in school-aged children.J Pediatr Urol. 2016 Jun; 12: 159.e1-159.e6
- Prevalence of nocturnal enuresis and its associated factors in primary school and preschool children of khorramabad in 2013.Int J Pediatr. 2014;Oct 12; 2014120686
- Prevalence and risk factors of nocturnal enuresis among children ages 5–12 years in Xi’an, China: a cross-sectional study.BMC Pediatr. 2020 Dec; 20: 1-8
- Bed‐wetting in Chinese children: Epidemiology and predictive factors.Neurourol Urodynamics. 2007 Jul; 26: 512-517
- Refugee status as a possible risk factor for childhood enuresis.Int. J. Environ. Res Public Health. 2019 Jan; 16: 1293
- Stressful events in early childhood and developmental trajectories of bedwetting at school age.J Pediatr Psychol. 2016 Oct 1; 41: 1002-1010
- Nocturnal enuresis.BMJ Clin Evid. 2011 Jan 31; : 2011
- Frequency of nocturnal enuresis in rural areas of Sialkot.Pak J Med Health Sci. 2016 Jan 1; 10: 253-255
- Frequency and features of nocturnal enuresis in Pakistani children aged 5 to 16 years based on ICCS criteria: a multi-center cross-sectional study from Karachi, Pakistan.BMC Fam Pract. 2018 Dec; 19: 1-9
- Alarm interventions for nocturnal enuresis in children.Cochrane Database of Systematic Reviews. 2005;
- Comparison of the efficacy of desmopressin fast-melting formulation and enuretic alarm in the treatment of monosymptomatic nocturnal enuresis.J Pediatr Urol. 2020 Oct 1; 16: 645-e1
- Desmopressin versus desmopressin+ oxybutynin in the treatment of children with nocturnal enuresis.J Pediatr Urol. 2021 Aug 1; 17: 451-e1
- Comparison of combined treatment with desmopressin plus oxybutynin and desmopressin plus tolterodine in treatment of children with primary nocturnal enuresis.J Renal Inj Prev. 2015; 4: 80-86
- STAR study group. a comparison of the efficacy and tolerability of solifenacin succinate and extended release tolterodine at treating overactive bladder syndrome: results of the STAR trial.Eur Urol. 2005 Sep 1; 48: 464-470
- Desmopressin for nocturnal enuresis in children.Cochrane Database Syst Rev. 2002; 3
- Failure of monotherapy in primary monosymptomatic enuresis: a combined desmopressin and propiverine treatment regimen improves efficacy outcomes.BJU Int. 2009; 103: 1706-1712
- Desmopressin and oxybutynin in monosymptomatic nocturnal enuresis: a randomized, double‐blind, placebo‐controlled trial and an assessment of predictive factors.BJU international. 2012 Oct; 110: E381-E386
- The role of bladder capacity in antidiuretic and anticholinergic treatment for nocturnal enuresis.J Urol. 2006 Aug; 176: 764-769
- Comparison of desmopressin, alarm, desmopressin plus alarm, and desmopressin plus anticholinergic agents in the management of paediatric monosymptomatic nocturnal enuresis: a network meta‐analysis.BJU Int. 2019 Mar; 123: 388-400
- Desmopressin alone versus desmopressin and an anticholinergic in the first-line treatment of primary monosymptomatic nocturnal enuresis: a multicenter study.Pediatr Nephrol. 2014 Jul; 29: 1195-1200
- A comparison of the efficacy and tolerability of treating primary nocturnal enuresis with solifenacin plus desmopressin, tolterodine plus desmopressin, and desmopressin alone: a randomized controlled clinical trial.Int Braz J Urol. 2020 Nov 18; 47: 73-81
- Solifenacin in children and adolescents with overactive bladder: results of a phase 3 randomised clinical trial.European Urology. 2017 Mar 1; 71: 483-490
- Efficacy and tolerability of solifenacin 5 mg fixed dose in Korean children with newly diagnosed idiopathic overactive bladder: a multicenter prospective study.J Korean Med Sci. 2017 Feb 1; 32: 329-334
Article info
Publication history
Accepted:
March 13,
2023
Received in revised form:
March 9,
2023
Received:
September 24,
2022
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.