Zhai Rongqun, Shao Sida, Lv Lei, Li Shuai, Wang Yihe, Zhang Yanping, Li Qingli, Wen Yibo, Yang Jing, Zhang Huiqing, Lu Wei, Zhou Chaoming, Wu Guoxing, Wang Qingwei, Wen Jian Guo
Department of Pediatric Surgery & Department of Otology, Henan Joint International Pediatric Urodynamic Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
Department of Pediatric Surgery, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453000, China.
Pediatr Nephrol. 2025 Jun 10. doi: 10.1007/s00467-025-06840-z.
To compare the therapeutic effect of desmopressin (DDAVP) and enuresis alarm (EA) in treating primary monosymptomatic nocturnal enuresis (MNE) and identified prognostic factors.
A total of 213 children (6-16 years) with MNE were randomized to the DDAVP or EA group at five hospitals in mainland China from January 2019 to December 2023. Comprehensive medical histories were collected, and voiding diaries were maintained for two consecutive weeks. All participants underwent 12-week follow-up evaluations, with therapeutic outcomes assessed at the endpoint. Children achieving complete response were monitored for relapse for an additional 3 months post-treatment.
After excluding 28 patients (16 lost to follow-up, 12 incomplete diaries), 185 completed the study (63.24% male, mean age 10.25 ± 2.36 years). The loss to follow-up rate in the EA group was higher than in the DDAVP group (11.71% vs. 2.94%, P < 0.05). Ninety-four children were treated with EA and 91 children with DDAVP. After 12 weeks, there was no significant difference in the therapeutic effect between the DDAVP and EA group (P > 0.05). Relapses occurred in 1/30 children in the EA group and 6/30 children in the DDAVP group (P < 0.05). Family history (OR = 2.37, 95%CI: 1.16-4.84), enuresis frequency > 4 times/week (OR = 2.30, 95%CI: 1.08-4.89), and reduced bladder capacity (OR = 2.29, 95%CI: 1.12-4.66) were negative prognostic factors.
Both therapies showed comparable short-term efficacy, but EA exhibited superior durability with lower relapse. Family history, severity of enuresis, and reduced bladder capacity are negative prognostic factors for therapeutic effect.
比较去氨加压素（DDAVP）和遗尿报警器（EA）治疗原发性单纯性夜间遗尿症（MNE）的疗效，并确定预后因素。
2019年1月至2023年12月期间，中国大陆五家医院的213名6至16岁的MNE患儿被随机分为DDAVP组或EA组。收集全面的病史，并连续两周记录排尿日记。所有参与者均接受为期12周的随访评估，在终点时评估治疗结果。对达到完全缓解的儿童在治疗后额外监测3个月的复发情况。
排除28例患者（16例失访，12例日记记录不完整）后，185例完成研究（男性占63.24%，平均年龄10.25±2.36岁）。EA组的失访率高于DDAVP组（11.71%对2.94%，P<0.05）。94例儿童接受EA治疗，91例儿童接受DDAVP治疗。12周后，DDAVP组和EA组的治疗效果无显著差异（P>0.05）。EA组30例儿童中有1例复发，DDAVP组30例儿童中有6例复发（P<0.05）。家族史（OR=2.37，95%CI：1.16-4.84）、遗尿频率>4次/周（OR=2.30，95%CI：1.08-4.89）和膀胱容量减小（OR=2.29，95%CI：1.12-4.66）是负面预后因素。
两种疗法均显示出相当的短期疗效，但EA的耐久性更佳，复发率更低。家族史、遗尿严重程度和膀胱容量减小是治疗效果的负面预后因素。
