Desmopressin versus solifenacin as a treatment of primary nocturnal enuresis in children more than 6 years old ( comparative study)

Abstract

Background :Nocturnal enuresis is a common condition that affects children with greater impact on self-esteem and psychiatric status of an individual.

Aim of the study :To compare between the outcomes and side effects of desmopressin and solifenacin in children  with primary nocturnal enuresis.

Patients and methods  :Between March 2025 and March 2026 a prospective study was performed in al hussain teaching hospital (al muthana governorate) The study included 100 children patients were between 6 and 14 years and had been diagnosed as primary nocturnal enuresis. The patients were randomized into two groups of equal numbers. One of the group was given desmopressin and another was treated with solifenacin. Response rates and adverse events were recorded and compared between the two groups.

Results  :Overall response to desmopressin was significantly higher than that to solifenacin during follow-up period of treatment (40% at 1 month, 76% at 3 months and

82% at 6 months versus

22% at 1 month, 42% at 3 months and 46% at 6 months, p-value less than 0.001). At 6 months of treatment complete response was achieved in 31(62%) and 10(20%) in desmopressin and solifenacin groups respectively, while 10(20%) of desmopressin group and 13(26%) of solifenacin group showed partial response. No response to treatment was recorded in 9(18%) & 27(54%) out of desmopressin and solifenacin groups respectively.Three months post treatment withdrawal 25(60.9%) of patient taking desmopressin and 16(69.5%) of children on solifenacin relapsed. Twelfth percent of children in solifenacin group developed treatment related adverse effects in comparison to only 4% of desmopressin-treated patients with none of those effects were severe enough to discontinue the treatment.

Univariable and multivariable analysis of factors predicting patient’ response to treatment have shown that increased frequency of enuritic episodes was negatively correlated with response.

Conclusion  :Desmopressin was more effective and safer drug for treatment of noctunal enuresis in children more than 6 years old but with  statistical non signifcant high withdrawal relapse rate in comparsion with solifenacin