To explore the effect and compare the relapse rates of 1-desamino-8-D-Arginine Vasopressin(DDAVP) different withdrawal ways after initial 3 months in primary monosymptomatic nocturnal enuresis(PMNE) patients, in order to provide some evidences and references to use DDAVP to cure PMNE preferably.

Two hundred and fifty-six cases PMNE patients who were treated in Hubei Maternal and Child Health Hospital from November 2014 to June 2016 were selected and randomly divided into group A(DDAVP immediate withdrawal group, 65 cases), group B(DDAVP day reduction group, 58 cases) and group C(DDAVP step reduction group, 60 cases). All patients were given DDAVP tables for 3 months.After 3 months for DDAVP, patients who were effective(full respond and partial respond) to DDAVP continued to undergo a withdrawal stage, those in group A underwent immediate cessation, those in group B continued to receive the effective dose every other day for 2 months and those in group C were step by step tapered by 0.05-0.10 mg every 2-4 weeks until completely stopped, the period was not more than 3 months.All patients had a follow-up visit for 3 months after cessation of DDAVP.

A total of 183 patients completed the study finally, there were 65 patients in group A, 58 patients in group B and 60 patients in group C. Initial 3 months the effective rates of group A, B and C were respectively 89.23%(58/65), 89.66%(52/58) and 86.67%(52/60), there were not statistically significant difference(χ²=0.309, P=0.857). There were 58 patients in group A, 52 patients in group B and 52 patients in group C continued to undergo the withdrawal stage.One month after cessation of DDAVP, the effective rates of group B(88.46%, 46/52) and group C(92.31%, 48/52) were significantly higher than group A(67.24%, 39/58)(χ²=7.030, P=0.008; χ²=10.417, P=0.001), while the relapse rates of group B(19.23%, 10/52) and group C(17.31%, 9/52) were significantly less than group A(36.21%, 21/58)(χ²=3.904, P=0.048; χ²=4.937, P=0.026). Three months after cessation of DDAVP, the effective rates of group C(78.85%, 41/52) were significantly higher than group A(50.00%, 29/58) and group B(57.69%, 30/52)(χ²=9.859, P=0.002; χ²=5.371, P=0.020), and the relapse rates of group C(32.69%, 17/52) were significantly less than group A(55.17%, 32/58) and group B(51.92%, 27/52)(χ²=5.609, P=0.018; χ²=3.939, P=0.047), while the effective rates and relapse rates were not statistically significant difference between group A and group B(χ²=0.652, P=0.419; χ²=0.116, P=0.733). Severe adverse events related to DDAVP were not observed in any patients.

Gradual withdrawal after initial 3 months of DDAVP may improve the effect and reduce the relapse rates, the short-term and long-term curative effects of step-by-step withdrawal treatment are both well, while long-term curative effects of every other day withdrawal treatment is not obviously well.

Enuresis; Desmopressin; Child