Melatonin’s Effect on the Efficacy of Desmopressin in the Treatment of Enuresis
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
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.
Abstract
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.
참고문헌 (31)
- Austin PF, "The standardization of terminology of lower urinary tract function in children and adolescents: update report from the Standardization Committee of the International Children’s Continence Society", J Urol, 191, pp.1863~1865 (2014)
- American Psychiatric Association, "Diagnostic and statistical manual of mental disorders, 5th ed (DSM-V)" (2013), American Psychiatric Publishing
- Deshpande AV, "Medical management of nocturnal enuresis", Paediatr Drugs, 14, pp.71~77 (2012)
- Robson WL, "Primary and secondary nocturnal enuresis: similarities in presentation", Pediatrics, 115, pp.956~959 (2005)
- Neveus T, "Enuresis--background and treatment", Scand J Urol Nephrol Suppl, (206), pp.1~44 (2000)
- Bakker E, "Voiding habits and wetting in a population of 4,332 Belgian schoolchildren aged between 10 and 14 years", Scand J Urol Nephrol, 36, pp.354~362 (2002)
- Fergusson DM, "Factors related to the age of attainment of nocturnal bladder control: an 8-year longitudinal study", Pediatrics, 78, pp.884~890 (1986)
- Howe AC, "Behavioral management of toilet training, enuresis, and encopresis", Pediatr Clin North Am, 39, pp.413~432 (1992)
- Yeung CK, "Characteristics of primary nocturnal enuresis in adults: an epidemiological study", BJU Int, 93, pp.341~345 (2004)
- Chiozza ML, "An Italian epidemiological multicentre study of nocturnal enuresis", Br J Urol, 81(Suppl 3), pp.86~89 (1998)
- Robson WL, "Clinical practice: evaluation and management of enuresis", N Engl J Med, 360, pp.1429~1436 (2009)
- Butler RJ, "Annotation: night wetting in children: psychological aspects", J Child Psychol Psychiatry, 39, pp.453~463 (1998)
- Rogers J, "An overview of the management of nocturnal enuresis in children", Br J Nurs, 12, pp.898~903 (2003)
- Theunis M, "Self-image and performance in children with nocturnal enuresis", Eur Urol, 41, pp.660~667 (2002)
- Caldwell PH, "Simple behavioural interventions for nocturnal enuresis in children", Cochrane Database Syst Rev, (7), pp.CD003637~ (2013)
- Ferrara P, "Homotoxicological remedies versus desmopressin versus placebo in the treatment of enuresis: a randomised, doubleblind, controlled trial", Pediatr Nephrol, 23, pp.269~274 (2008)
- van Gool JD, "Subtypes in monosymptomatic nocturnal enuresis. II", Scand J Urol Nephrol Suppl, 202, pp.8~11 (1999)
- Ardura-Fernandez J, "Melatonin rhythm in children with enuresis", BJU Int, 99, pp.413~415 (2007)
- Kennaway DJ, "Potential safety issues in the use of the hormone melatonin in paediatrics", J Paediatr Child Health, 51, pp.584~589 (2015)
- Kennaway DJ, "Melatonin and circadian rhythms", Curr Top Med Chem, 2, pp.199~209 (2002)
- Szeinberg A, "Melatonin treatment in adolescents with delayed sleep phase syndrome", Clin Pediatr (Phila), 45, pp.809~818 (2006)
- Ferrara P, "Combined dietary recommendations, desmopressin, and behavioral interventions may be effective first-line treatment in resolution of enuresis", Urol J, 12, pp.2228~2232 (2015)
- Nevéus T, "The standardization of terminology of lower urinary tract function in children and adolescents: report from the Standardisation Committee of the International Children’s Continence Society", J Urol, 176, pp.314~324 (2006)
- Hardeland R, "Melatonin: a pleiotropic, orchestrating regulator molecule", Prog Neurobiol, 93, pp.350~384 (2011)
- Rittig S, "Abnormal diurnal rhythm of plasma vasopressin and urinary output in patients with enuresis", Am J Physiol, 256(4 Pt 2), pp.F664~F671 (1989)
- Skene DJ, "Use of melatonin in the treatment of phase shift and sleep disorders", Adv Exp Med Biol, 467, pp.79~84 (1999)
- Merks BT, "Melatonin treatment in children with therapy-resistant monosymptomatic nocturnal enuresis", J Pediatr Urol, 8, pp.416~420 (2012)
- Ferrara P, "Oral desmopressin lyophilisate (MELT) for monosymptomatic enuresis: structured versus abrupt withdrawal", J Pediatr Urol, 10, pp.52~55 (2014)
- Ferrara P, "Possible impact of comorbid conditions on the persistence of nocturnal enuresis: results of a long-term follow-up study", Urol J, 11, pp.1777~1782 (2014)
- Guzelsoy M, "Impact of urinary incontinence on quality of life among residents living in Turkey", Urol J, 11, pp.1447~1451 (2014)
- Shadpour P, "Enuresis persisting into adulthood", Urol J, 3, pp.117~129 (2006)
