Multiparameter evaluation of male adults with primary nocturnal enuresis and response to long term desmopressin treatment

It has been reported that most of the patients with nocturnal enuresis have bladder dysfunction. But the patient population of these studies included neurological or metabolic disorders. In the present study, we aimed to evaluate the depression profile and response to desmopressin in nocturnal enuretic adults with normal urodynamic findings. Forty-eight male adults with nocturnal enuresis were prospectively evaluated according to their filling cystometry and 8 of them were excluded from the study because of overactive bladder. Beck depression test was applied to 40 study subjects. All study subjects were administrated 0.2 mg/day desmopressin acetate for 2 weeks, orally. Dosage was titrated up to 0.4 mg/day for non-responders and enuresis frequency was recorded bimonthly for the following 6 months with the re-evaluation of Beck depression test. Five patients were found as non-responder to desmopressin acetate. No side effects were recorded. Nocturnal enuretic episodes have displayed a progressive decrease during the bimonthly control period. At the end of six months, significant improvement was recorded in terms of Beck depression test. After discontinuation of the medication, enuretic episodes have started to increase. Over activity for bladder was found as 17% for our pure nocturnal enuretic adult subjects. The remaining 88% of the subjects were responded to desmopressin acetate and that level of response increased during the six months treatment period. Discontinuation of this treatment yielded to the recurrence of the enuresis.