Comparison of Efficacy of Desmopressin and Enuresis Alarm in the Treatment of Monosymptomatic Enuresis and Prognostic Factors: A Multicenter Prospective Randomized Controlled Study in Mainland China

Shao S1, Wen J2, Zhai R2, Lv L2, Jia W3, Zhou C4, Wang Q5

Research Type

Clinical

Abstract Category

Nocturia

Abstract 273
Urology 9 - Nocturia: from Basics to Clinics
Scientific Podium Short Oral Session 23
Saturday 20th September 2025
12:00 - 12:07
Parallel Hall 2
Pediatrics Nocturia Nocturnal Enuresis Retrospective Study Prospective Study
1. Department of Pediatric Surgery, The First Affiliated Hospital of Xinxiang Medical University, 2. Pediatric Urodynamic Center, Department of Urology, The First Affiliated Hospital of Zhengzhou University, Henan Joint Intonational Pediatric Urodynamic Laboratory, 3. Guangzhou Women and Children Medical Center, Guangzhou Medical University, China, 4. Department of Urology, Fujian Children Hospital, China, 5. Department of Urology of First Affiliated Hospital of Zhengzhou University, China,
Presenter
Links

Abstract

Hypothesis / aims of study
This is an orginal multicenter prospective randomized controlled study on comparing the efficacy of desmopressin (DDAVP) and enuresis alarm (EA) in treating children with monosymptomatic nocturnal enuresis (MNE) in mainland China.
Study design, materials and methods
A total of 213 children (6–16 years) with primary MNE from five hospitals were enrolled. Exclusion criteria included prior enuresis treatment, daytime urinary symptoms, or comorbidities. Participants were randomized into DDAVP (n=91) or EA (n=94) groups. DDAVP was administered nightly (0.2 mg), while EA utilized the Wet-Stop3 Blue alarm. Efficacy was assessed at 12 weeks using ICCS criteria: complete response (0 enuresis), partial response (50–99% reduction), or no response (<50% reduction)[1]. Relapse rates were recorded 3 months post-treatment. Univariate and multivariate logistic regression analyzed prognostic factors.
Results
Of 185 children completing follow-up, no significant difference in efficacy was observed between DDAVP and EA groups at 12 weeks (complete response: 32.97% vs. 31.91%, p>0.05). However, relapse rates were significantly higher in the DDAVP group (20.00% vs. 3.33%, p=0.044). Loss to follow-up was higher in the EA group compared to DDAVP group (11.71% vs. 2.94%, p<0.05). A univariate logistic regression analysis was conducted to explore the factors influencing the prognosis of enuresis treatment at the 12 – week mark, with complete or partial response as the treatment outcome. The results indicated that a family history of enuresis, enuresis frequency of more than 4 nights per week, reduced bladder capacity, and nocturnal polyuria were correlated with the treatment effect in enuretic children. Conversely, factors such as age, body mass index (BMI), gender, constipation, and difficulty awakening did not show a significant correlation with the treatment outcome, as evidenced byp – values greater than 0.05 for these variables (Table 1). Multivariate analysis identified family history (OR=2.37, 95% CI:1.16–4.84), enuresis frequency >4/week (OR=2.30, 95% CI:1.08–4.89), and reduced bladder capacity (OR=2.29, 95% CI:1.12–4.66) as negative prognostic factors (Table 2).
Interpretation of results
Both therapies demonstrated comparable short-term efficacy, but EA showed superior sustainability with lower relapse. Compliance challenges in the EA group may explain higher attrition, while DDAVP’s pharmacological limitations likely contributed to relapse. Prognostic factors highlight the need for personalized treatment strategies, particularly for children with familial predisposition, severe symptoms, or bladder dysfunction.
Concluding message
DDAVP and EA are equally effective for MNE, yet EA offers long-term advantages with fewer relapses. Clinicians should consider family history, symptom severity, and bladder capacity when selecting therapies. Extended treatment duration or combination regimens may improve outcomes for high-risk patients.
Figure 1 Table.1 Univariate Logistic regression analysis of risk factors affecting treatment outcomes in MNE children
Figure 2 Table.2 Multivariate Logistic regression analysis of risk factors affecting treatment outcomes in MNE children
References
  1. Pedersen MJ, Rittig S, Jennum PJ, Kamperis K. The role of sleep in the pathophysiology of nocturnal enuresis [J]. Sleep Med Rev, 2020, 49: 101228. DOI: 10.1016/j.smrv.2019.101228.
Disclosures
Funding National Natural Science Foundation of China(82470807) Clinical Trial Yes Public Registry No RCT Yes Subjects Human Ethics Committee Ethics Committee of the First Affiliated Hospital of Zhengzhou University Helsinki Yes Informed Consent Yes
07/07/2025 09:14:04