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BJU Int. 2010 May;105(10):1456-9. doi: 10.1111/j.1464-410X.2009.08872.x. Epub 2009 Sep 17.

Evaluation of different modes of combined therapy in children with monosymptomatic nocturnal enuresis.

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Department of Paediatric Surgery, University of Leipzig, Leipzig, Germany.



To evaluate the efficacy of different modes of combined therapy in children with monosymptomatic nocturnal enuresis (MNE).


A randomized prospective study was performed to compare the order of two types of combined therapy in children with MNE. Group A was treated with primary desmopressin treatment that was combined with alarm treatment after 3 months, while group B was treated with primary alarm treatment that was combined with desmopressin after 3 months.


Within a period of 18 months, 43 previously untreated children fulfilled the inclusion criteria. Thirteen children achieved dryness after initial monotherapy or discontinued the study. Group A consisted of 16 children and group B of 14 children. After the standardized treatment course of 6 months, 11/16 children in group A and 11/14 children in group B became dry (<3 wet nights/month). Altogether, 22/30 (73%) children were dry after combined treatment, consisting of 12/18 boys and 10/12 girls. Of the children with a normal maximum voided volume, 79% (19/24) achieved dryness, whereas only three of six children with small maximum voided volumes became dry. In all, 13/19 (68%) children with nocturnal polyuria and nine of 11 without nocturnal polyuria became dry. Only one child relapsed (group A).


Combined therapy proved effective in children with MNE after 6 months, with no statistically significant differences between the two different orders of treatment.

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