Yeungnam Univ J Med.  2015 Dec;32(2):85-89. 10.12701/yujm.2015.32.2.85.

Role of urine osmolality as a predictor of the effectiveness of combined imipramine and desmopressin in the treatment of monosymptomatic nocturnal enuresis

• Lee KS
• Chang JB
• Jang JY
• Ko YH
• Park YH
• Song PH

• KMID: 2319905
• DOI: http://doi.org/10.12701/yujm.2015.32.2.85

Abstract

BACKGROUND
We examined the usefulness of urine osmolality, as a predictive factor in the treatment of monosymptomatic nocturnal enuresis (NE) with combination therapy of imipramine and desmopressin.
METHODS
From May 2014 to April 2015, 59 monosymptomatic NE patients participated in this study. Early morning urine osmolality was measured at 1 week and 1 day before combination therapy of imipramine and desmopressin, and at 1 week and 2 weeks after therapy. The response to combination therapy was evaluated at 3 months after treatment. The mean period of combination therapy was 6.4+/-4.2 weeks. Therapeutic response was classified as complete (0-1 wet night/week), partial (over 50% reduction of night) and non-responders (less than 50% reduction of night).
RESULTS
The cumulative rate of the complete and partial responders was 76.3%. Among the 3 groups, the statistically lowest value of pre-treatment urine osmolality was observed in the complete responder group (p<0.001). Urine osmolality increased in all groups after treatment, however, statistically the greatest difference between pre and post-treatment urine osmolality was observed in the complete responder group (p=0.024). No serious side effects were observed.
CONCLUSION
Early morning urine osmolality and change of urine osmolality between pre and post-treatment have predictive values in the response to combined imipramine and desmopressin for treatment of monosymptomatic NE.

Keyword

Enuresis; Urine; Osmolality

MeSH Terms

Deamino Arginine Vasopressin*
Enuresis
Humans
Imipramine*
Nocturnal Enuresis*
Osmolar Concentration*
Deamino Arginine Vasopressin
Imipramine