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Efficacy of desmopressin and enuresis alarm as first and second line treatment for primary monosymptomatic nocturnal enuresis: prospective randomized crossover study.

By K.W. Kwak, Y.-S. Lee, K.H. Park, and M. Baek.

Journal of Urology, Volume 184, Issue 6, December 2010, Pages 2521-2526

Editor's comments:
Desmopressin and alarm treatment have a similar primary success rate and switching of treatment can be beneficial.This study has focused on the success rate of desmopressin and alarm as a primary treatment or a second line crossover treatment if the first treatment was unsuccessful.  104 children were included in the prospective study.  Following the first line treatment 78% of the desmopressin group and 82% of the alarm treatment had a partial or full response.  Following the second line crossover treatment, 71% of the alarm-desmopressin group and 68% of the desmopressin-alarm group achieved partial or full response [18]. In addition, the authors have found that the relapse rate after desmopressin was higher than after the alarm treatment.  The authors stated that switching to the alternative treatment was beneficial.


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Consensus Guidelines

Practical consensus guidelines for the management of enuresis. 
Evaluation and management of enuresis, a common condition, is not a priority in training programs for medical doctors (MDs), despite being a common condition.