Subtypes in monosymptomatic nocturnal enuresis. II.

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