Constipation impedes desmopressin treatment success in nocturnal enuresis
Response to desmopressin treatment for nocturnal enuresis (NE) in children appears to be compromised in the presence of constipation, particularly in children with severe enuresis and those prescribed low doses, as reported in a recent study.
The study included 383 paediatric patients (52.7 percent boys) aged 5–15 years, among whom 126 (32.9 percent) had primary NE and 257 (67.1 percent) had secondary NE. About a third of the population had a family history of NE (32.6 percent), and 14 percent of patients presented with constipation.
Severe enuresis was more common among patients with constipation than among nonconstipated controls (94.4 percent vs 72.9 percent; p=0.001). NE severity was significantly correlated to responses to desmopressin treatment (p=0.026).
Patients with constipation had significantly lower complete response rate relative to those without constipation. Of note, there was a significant association seen between constipation and the effectiveness of desmopressin both among monosymptomatic NE or nonmonosymptomatic patients with NE.
Complete response rate was also significantly lower in constipated vs nonconstipated patients in the subgroup of those who received 0.2 mg of desmopressin. On the other hand, constipation showed no significant association with treatment response in subgroups of patients with mild-to-moderate NE and 0.4-mg desmopressin.
More studies on subclassification of enuretic patients with a large sample size are warranted to verify the association between constipation and the effectiveness of desmopressin, researchers said.