Parasacral Transcutaneous Electrical Nerve Stimulation with Desmopressin Acetate for Treating Primary Monosymptomatic Enuresis: A Randomized Controlled Clinical Trial

ABSTRACT Purpose: Approximately one-third of the children with primary monosymptomatic enuresis (PMNE) do not respond to first-line treatment. We aimed to investigate the short-term and six-month effectiveness of combining desmopressin acetate with parasacral transcutaneous electrical nerve stimula...

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Main Authors: Melissa Faria Dutra, Eleonora Moreira Lima, José Murillo Bastos Netto, Lidyanne Ilídia da Silva de Paula, José de Bessa Júnior, Amanda Lima Alves Pereira, Glaúcia Cristina Medeiros Dias, Mônica Maria de Almeida Vasconcelos, Flávia Cristina de Carvalho Mrad
Format: Article
Language:English
Published: Sociedade Brasileira de Urologia 2025-08-01
Series:International Brazilian Journal of Urology
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Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382025000500402&lng=en&tlng=en
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Summary:ABSTRACT Purpose: Approximately one-third of the children with primary monosymptomatic enuresis (PMNE) do not respond to first-line treatment. We aimed to investigate the short-term and six-month effectiveness of combining desmopressin acetate with parasacral transcutaneous electrical nerve stimulation (PTENS) in these children and adolescents. Materials and Methods: Participants aged six–17 years with PMNE were randomly assigned to receive desmopressin acetate with active or sham PTENS. Both groups participated in weekly 30-minute electrotherapy sessions for 15 weeks. The intervention group (IG) received electrotherapy at a frequency of 10 Hz and pulse width of 700 μs. A dry and wet nights calendar assessed the frequency of wet nights in the short term and six months after the intervention ended. Results: Of 66 participants, 34 were randomized to the IG. The median age was 10.3 years (8.8 – 12), and 53% were male. Intention-to-treat analysis showed a significant reduction in the frequency of wet nights after the interventions (p <0.001) in both groups, with the IG demonstrating significant improvement, immediately after the interventions (p=0.005) and after six months (p<0.001) compared to the placebo group (PG). The Kaplan-Meier survival analysis showed improvement in the IG that became more pronounced from the 15th week onwards (log-rank test, p < 0.01). Conclusions: A 15-week treatment with desmopressin acetate and PTENS significantly reduced wet nights in children and adolescents with PMNE, and this improvement was maintained six months after the interventions.
ISSN:1677-6119