Desmopressin, Alarm ya da Kombine Tedavi? Primer Monosemptomatik Noktürnal Enürezisli Çocuklarda Etkinlik ve Nüksün Değerlendirilmesi

Abstract

Giriş: Monosemptomatik noktürnal enürezis (MNE), çocuklarda özgüven ve aile düzenini olumsuz etkileyen yaygın bir durumdur. Enürezis alarmı ve desmopressin birinci basamak tedavi seçenekleri arasında yer almakta, ancak etkinlik ve nüks oranları hâlâ tartışılmaktadır. Amaç: Bu çalışmanın amacı, primer MNE tanılı çocuklarda desmopressin, alarm tedavisi ve kombine tedavinin kısa dönem tedavi sonuçları ile nüks oranlarını karşılaştırmaktır. Gereç ve Yöntem: Bu retrospektif iki merkezli çalışmaya, Eylül 2022 ile Ocak 2025 tarihleri arasında MNE tanısı alan 202 çocuk dahil edildi. Hastalar desmopressin monoterapisi (n=124), alarm tedavisi (n=45) ve kombine tedavi (n=33) gruplarına ayrıldı. Demografik veriler, tedavi yanıtları ve nüks oranları değerlendirildi. Bulgular: Tam yanıt oranları desmopressin grubunda %39,5, alarm grubunda %42,2 ve kombine grupta %63,6 idi. Nüks oranı desmopressin grubunda %48,4, alarm grubunda %33,3 ve kombine grupta %30,3 olarak saptandı. Kombine tedavi sayısal olarak daha iyi sonuç verse de fark istatistiksel olarak anlamlı değildi (p>0,05). Sonuç: Primer MNE tedavisinde desmopressin, alarm tedavisi ve kombine tedavi etkili seçeneklerdir. Kombine tedavi bazı hastalarda ek fayda sağlayabilir, ancak bu çalışmada belirgin bir üstünlük göstermemiştir. Tedavi planı, bireysel faktörler ve aile uyumu göz önünde bulundurularak yapılmalıdır.

Keywords

• Monosemptomatik Noktürnal Enürezis
• Desmopressin
• Enürezis Alarmı

Desmopressin, Alarm, or Both? Evaluating Efficacy and Relapse in Children with Primary Monosymptomatic Nocturnal Enuresis

Abstract

Background: Monosymptomatic nocturnal enuresis (MNE) is a common pediatric condition that affects a child’s self-esteem and daily family life. Both enuresis alarm and desmopressin are recommended as first-line treatment options, but their comparative effectiveness and relapse rates remain subjects of discussion. Aim: This study aimed to compare the short-term treatment outcomes and relapse rates of desmopressin, alarm therapy, and combination therapy in children with primary MNE. Materials and Methods: This retrospective two-center study included 202 children diagnosed with MNE between September 2022 and January 2025. Patients were grouped into desmopressin monotherapy (n=124), alarm therapy (n=45), and combination therapy (n=33). Demographic data, treatment responses, and relapse rates were evaluated. Results: Complete response rates were 39.5% for desmopressin, 42.2% for alarm therapy, and 63.6% for the combination group. Relapse occurred in 48.4% of the desmopressin group, 33.3% of the alarm group, and 30.3% of the combination group. Although the combination group showed higher response rates and lower relapse rates, these differences were not statistically significant (p>0.05). Conclusion: Desmopressin, alarm therapy, and their combination are effective options for the treatment of primary MNE. Combination therapy may provide added benefit in selected patients, but no clear superiority was demonstrated in this study. Treatment plans should consider individual factors such as nocturnal urine output and family compliance.

Keywords

• Monosymptomatic nocturnal enuresis
• Desmopressin
• Enuresis alarm

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