Literature DB >> 27067081

Desmopressin (melt) therapy in children with monosymptomatic nocturnal enuresis and nocturnal polyuria results in improved neuropsychological functioning and sleep.

Charlotte Van Herzeele1, Karlien Dhondt2, Sanne P Roels3, Ann Raes4, Piet Hoebeke4, Luitzen-Albert Groen4, Johan Vande Walle4.   

Abstract

BACKGROUND: There is a high comorbidity between nocturnal enuresis, sleep disorders and psychological problems. The aim of this study was to investigate whether a decrease in nocturnal diuresis volume not only improves enuresis but also ameliorates disrupted sleep and (neuro)psychological dysfunction, the major comorbidities of this disorder.
METHODS: In this open-label, prospective phase IV study, 30 children with monosymptomatic nocturnal enuresis (MNE) underwent standardized video-polysomnographic testing and multi-informant (neuro)psychological testing at baseline and 6 months after the start of desmopressin treatment in the University Hospital Ghent, Belgium. Primary endpoints were the effect on sleep and (neuro)psychological functioning. The secondary endpoint was the change in the first undisturbed sleep period or the time to the first void.
RESULTS: Thirty children aged between 6 and 16 (mean 10.43, standard deviation 3.08) years completed the study. The results demonstrated a significant decrease in periodic limb movements during sleep (PLMS) and a prolonged first undisturbed sleep period. Additionally, (neuro)psychological functioning was improved on several domains.
CONCLUSIONS: The study demonstrates that the degree of comorbidity symptoms is at least aggravated by enuresis (and/or high nocturnal diuresis rate) since sleep and (neuro)psychological functioning were significantly ameliorated by treatment of enuresis. These results indicate that enuresis is not such a benign condition as has previously been assumed.

Entities:  

Keywords:  Children; Desmopressin; Periodic limb movements; Psychology; Quality of life

Mesh:

Substances:

Year:  2016        PMID: 27067081     DOI: 10.1007/s00467-016-3351-3

Source DB:  PubMed          Journal:  Pediatr Nephrol        ISSN: 0931-041X            Impact factor:   3.714


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9.  Long-term treatment with desmopressin in children with primary monosymptomatic nocturnal enuresis: an open multicentre study. Swedish Enuresis Trial (SWEET) Group.

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Review 1.  The pathophysiology of monosymptomatic nocturnal enuresis with special emphasis on the circadian rhythm of renal physiology.

Authors:  L Dossche; J Vande Walle; C Van Herzeele
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Review 2.  Pathogenesis and brain functional imaging in nocturnal enuresis: A review.

Authors:  Jiawen Dang; Zhanghua Tang
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Review 3.  Recent advances in managing and understanding enuresis.

Authors:  Charlotte Van Herzeele; Johan Vande Walle; Karlien Dhondt; Kristian Vinter Juul
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4.  Treatment of lower urinary tract dysfunction facilitates awakening and affects the cure rate in patients with nonmonosymptomatic enuresis.

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