No abstract available.
Child* ; Deamino Arginine Vasopressin* ; Humans ; Osmolar Concentration*

PURPOSE: It is well known that nocturia is a bothersome symptom that affects the quality of life (QoL). However, it is not known how much of a decrease in nocturnal frequency is needed to improve the QoL. We determined the minimal change in nocturnal frequency affecting the QoL of patients with nocturia. MATERIALS AND METHODS: A total of 87 patients with BPH and nocturia were treated with alpha-blocker and desmopressin for 8 weeks. Considering that the minimal clinically important change (MCIC) is different according to the baseline value, we divided the patients into two groups (group I, II). Group I had mild to moderate nocturia with voiding <4 times per night, and Group II had severe nocturia with voiding > or =4 times per night. Voiding diaries and King's Health Questionnaires (KHQs) were evaluated before and after treatment. To determine the minimal change in nocturia affecting the QoL, statistical analysis was performed by Student's t-test and ANOVA test with the change in KHQ score according to decreased numbers of nocturnal frequency. RESULTS: Groups I and II had 35 and 52 patients, respectively. The minimal decrease in nocturnal frequency associated with a statistically significant decrease in sleep/energy domain scores was 1 time in Group I and 2 times in Group II. CONCLUSIONS: These data show that decreases in nocturia of at least 1 time in patients with mild to moderate nocturia (<4 times/night) and of 2 times in patients with severe nocturia (> or =4 times/night) are needed to improve the QoL.
Deamino Arginine Vasopressin ; Humans ; Nocturia ; Quality of Life

No abstract available.
Child* ; Deamino Arginine Vasopressin* ; Humans ; Imipramine*

Desmopressin diacetate arginine vasopressin (DDAVP) is a synthetic analogue of the arginine vasopressin that is widely used in the treatment of diabetes insipidus, nocturnal enuresis, and polyuria. Although it is generally well-tolerated, DDAVP can cause hyponatremia, especially in elderly patients. There are many reports of DDAVP-induced hyponatremia, but there has been only one case report in which sinus node dysfunction was caused by severe hyponatremia. Here we report a case of sick sinus syndrome that occurred during an episode of severe hyponatremia induced by chronic use of desmopressin in a 91-year-old man who had nocturnal enuresis.
Aged ; Arginine Vasopressin ; Deamino Arginine Vasopressin* ; Diabetes Insipidus ; Humans ; Hyponatremia* ; Nocturnal Enuresis ; Polyuria ; Sick Sinus Syndrome*

The treatment of choice for primary nocturnal enuresis (PNE) in Korea remains imipramine which has proven to be effective in approximately 50 to 80%, but it is an antidepressant with toxic side effects and risk of overdose. Recently desmopressin (DDAVP, 1-desamino-8-Darginine-vasopressin) has been introduced for the treatment and its effect has been promising in many reports. To find the efficacy and safety of intranasal desmopressin, we evaluated the results of therapy in 48 enuretic children (34 boys and 14 girls). Mean age was 9.8 years (range 5-16). All the children were evaluated at least 3 months after the treatment with intranasal desmopressin. The overall response rate was 83.3%. The number of wet night per week before and after intranasal desmopressin treatment was 6.42 and 1.83 nights per week respectively. No side effects were observed. These data shows that the intranasal desmopressin therapy is effective and safe for the treatment of PNE.
Child ; Deamino Arginine Vasopressin* ; Enuresis ; Humans ; Imipramine ; Korea ; Nocturnal Enuresis*

PURPOSE: To evaluate the effectiveness of combined imipramine and desmopressin in the treatment of enuretic patients who did not respond to imipramine. MATERIALS AND METHODS: Initially 83 children were treated with imipramine, as a primary treatment for 4 weeks. To 38 patients who did not respond to imipramine, low-dose desmopressin were additionally given per os. During the study, the patients were divided into three categories; 1) complete responder with 0-1 wet nights per week, 2) intermediate responders with 2-3 wet nights per week and 3) non-responders with more than three wet nights per week. RESULTS: The response rate of combined imipramine and desmopressin was 73.7% (28/38) and 11 patients out of 28 patients showed recurrence after the discontinuation of medication. No serious side effects were observed. CONCLUSIONS: Combined therapy was effective in enuretic children who did not respond to imipramine treatment.
Child ; Deamino Arginine Vasopressin* ; Enuresis* ; Humans ; Imipramine* ; Recurrence

The understanding of nocturia has been much changed in last decade. Recently, nocturia has been recognized as a separate clinical entity within the lower urinary tract symptom complex. The pathophysiology of nocturia is multifactorial and can be complex and its cause remains unclear in a significant number of patients. Although the successful introduction of DDAVP to decrease nocturnal urine output in severe nocturia resistant to conventional treatment demonstrated new perspectives in management of nocturia, the primary treatment modality must be based on the disease. We reviewed the definition and etiologies of nocturia, offering the current diagnostic procedures and standards of care and we suggest practical tip for the management of nocturia.
Deamino Arginine Vasopressin ; Humans ; Nocturia ; Standard of Care ; Urinary Tract ; Urology

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

PURPOSE: This study aims to evaluate and compare the efficacy of exogenous melatonin associated with desmopressin (dDAVP) and dietary recommendations. METHODS: A total of 189 patients were enrolled from the Service of Pediatrics, Campus Bio-Medico University Hospital of Rome, from January 2013 to June 2015. Of the 189 original patients, 153 children, aged between 5 and 14 years (mean age, 8.7 years) were included in the study. After clinical evaluation and a 3-month period of observation without treatment, children were assigned to receive treatment in one of 3 groups: group 1, dDAVP at a dose of 120 mcg a day (Minirin); group 2, dDAVP at a dose of 120 mcg and dietary recommendations; or group 3, dDAVP at a dose of 120 mcg, dietary recommendations, and melatonin at a dose of 1 mg a day (Melamil plus). Each patient was treated for 3 months. RESULTS: After the 3 months of therapy, a desiderable response was achieved in 30 of 51 patients (58.82%) treated with dDAVP, 35 of 53 patients (66.04%) treated with dDAVP and dietary recommendations, and 35 of 49 patients (71.43%) treated with dDAVP, dietary recommendations, and melatonin. CONCLUSIONS: Although not statistically significant, the results show that the association between dDAVP treatment with dietary recommendations and melatonin could be considered a safe and effective treatment of NE. Considering that the statistically insignificant results might be due to the small sample size, the study will be continued to increase the number of subjects.
Child ; Deamino Arginine Vasopressin* ; Enuresis* ; Humans ; Melatonin ; Pediatrics ; Sample Size

OBJECTIVE: To assess the effect of oral desmopressin administration for nocturia and sleeping in brain injured patients and to confirm its safety. METHOD: 20 brain injured patients waking up more than twice a night for urination during sleeping have been subjected to take 0.1 mg of desmopressin at 9 p.m. everyday for 30 days. To analyze the effect of the drug before and after its administration, the frequency of patient's awakening for urination, duration of time to first urination after sleeping, total urination volume during sleeping and Pittsburgh sleep quality index (PSQI) were evaluated. All newly found symptoms one month after taking the medication were recorded to confirm the safety of the drug. RESULTS: After taking the medication, the mean urination frequency of 20 patients was reduced from 2.4 to 1.4, the mean duration of time to the first urination after sleeping was increased from 3.4 hours to 4.9 hours (p<0.01). The mean PSQI score of 20 patients was decreased from 9.7 to 4.8 (p<0.01). 2 patients had side effects (hyponatremia, headache). CONCLUSION: The oral administration of desmopressin was relatively safe and effective on brain injured patients with nocturia.
Administration, Oral ; Brain ; Deamino Arginine Vasopressin ; Humans ; Nocturia ; Urination