Usage of ultrasound indices in nocturnal enuresis treated with desmopressin therapy.

Abstract

Background: Nocturnal enuresis is a common problem in children and could be treated with desmopressin therapy. Here we assessed ultrasound indices affecting disease severity and treatment responses in candidates for pharmacotherapy for nocturnal enuresis.

Methods: This prospective study was conducted in 2021-2022 on children diagnosed with nocturnal enuresis and candidates for desmopressin therapy. Demographic data of patients including age and gender were collected by a checklist. The severity of the disease was categorized into mild, moderate and severe. We measured the bladder volume index (BVI), bladder wall thickness (BT) and bladder volume wall thickness index (BVWI) by ultrasound. Patients were treated with desmopressin (administered 120 µg, stat and before sleeping) for 4 months and treatment responses were determined and compared.

Results: In this study, data from 72 patients were analyzed. Complete response was achieved in 16 patients (22.2%), 25 patients (34.7%) had a good response to treatments, 18 patients (25%) had a partial response and 13 patients (18.1%) had no response. There was a significantly positive correlation between low and normal BVWI and the severity of the disease. Normal BVWI was found mostly in children with a mild degree of nocturnal enuresis; while low BVWI was associated with severe cases. There was a significant inverse correlation between response to treatment and bladder wall thickness. BVWI was significantly correlated with response to treatment. It was shown that 81.3% of children with complete responses and 76% of children with good responses had a normal BVWI, while 76.9% of children who showed no response to treatment had a low BVWI.

Conclusion: BVWI and bladder wall thickness were significantly correlated with treatment response and BVWI had significant correlations with disease severity.