University Children's Hospital Belgrade, Belgrade, Serbia.
Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
BMC Pediatr. 2021 May 20;21(1):244. doi: 10.1186/s12887-021-02714-z.
To evaluate the impact of compliance on the therapeutic effects of Desmopressin, as well as the importance of establishing the voiding school for low-compliance children in primary monosymptomatic enuresis treatment.
Eighty-nine patients with primary monosymptomatic enuresis treated with Desmopressin were observed during the 2017-2020 at University Children's Hospital Belgrade, Serbia. The average patients age was 7.7 ± 2.4 years; 65 (73%) were boys and 24 (27%) % were girls. After the 3 months of Desmopressin treatment, the effect of therapy was evaluated according to the compliance. After the treatment, low-compliance patients and their parents were suggested to visit a voiding school.
A significant decrease in the median enuresis frequency was noticed during the Desmopressin treatment (25.0 (20.0-26.0) vs 10.0 (2.0-17.0) per month, before vs after treatment, respectively) (p < 0.001). Patients with low compliance had a poorer response to Desmopressin (p < 0.001). An median enuresis reduction in the good compliance group was 92.3% (86.7 -95%), while in the low compliance group was 28.6% (16.7-43.3%). After attending voiding school, there was a significant increase in compliance (p < 0.001), associated with an median percent decrease in enuresis of 84.0% (75.0-95.5%) (p < 0.001).
Compliance considerably influences the beneficial effects of Desmopressin. Patients with poor therapeutic effects should be evaluated for compliance and introduced to voiding school.
评估顺应性对去氨加压素治疗效果的影响,以及在原发性单症状遗尿症治疗中为低顺应性儿童建立排尿学校的重要性。
在塞尔维亚贝尔格莱德大学儿童医院,观察了 2017 年至 2020 年期间 89 例接受去氨加压素治疗的原发性单症状遗尿症患者。患者平均年龄为 7.7±2.4 岁;65 例(73%)为男孩,24 例(27%)为女孩。去氨加压素治疗 3 个月后,根据顺应性评估治疗效果。治疗后,建议低顺应性患者及其家长去排尿学校就诊。
去氨加压素治疗期间,遗尿频率的中位数显著降低(25.0(20.0-26.0)与治疗前相比,治疗后为 10.0(2.0-17.0)/月,分别)(p<0.001)。低顺应性患者对去氨加压素的反应较差(p<0.001)。良好顺应性组的遗尿中位数减少 92.3%(86.7-95%),而低顺应性组为 28.6%(16.7-43.3%)。参加排尿学校后,顺应性显著增加(p<0.001),遗尿中位数百分比降低 84.0%(75.0-95.5%)(p<0.001)。
顺应性对去氨加压素的有益效果有很大影响。治疗效果不佳的患者应评估其顺应性,并介绍其参加排尿学校。