Urol. praxi, 2012; 13(1): 8-9

Treatment of refractory enuresis

MUDr.Oldřich Šmakal, CSc.

Urologická klinika LF UP a FN Olomouc

The principal treatment of monosymptomatic nocturnal enuresis with desmopressin or enuretic alarm has a success rate of 60-80% in an

unselected group of enuretic children. In patients not responding to first-line therapy, previous diagnostic and therapeutic management

must be re-evaluated carefully. Possible constipation and upper airway obstruction need to be addressed. When further improvements in

lifestyle measures and proper adherence to the principal treatment fail to solve the problem, second-line therapy is recommended. Combination

therapy with desmopressin and anticholinergics is most commonly administered. If enuresis continues to persist, treatment with

tricyclic antidepressants in monotherapy or, preferably, in combination with desmopressin is initiated. In the case of enuresis which remains

refractory to the treatment delivered, it is recommended to use all available treatment methods, including non-evidence-based ones.

Keywords: enuresis, treatment, desmopressin, anticholinergics, tricyclic antidepressants

Published: February 15, 2012  Show citation