A literature review of 18 randomized controlled trials of desmopressin for resistant enuresis involving 689 patients is reported from the University of Manitoba, Canada. Frequency of wetting decreased in all studies, ranging from 10% to 91%, and 25% of subjects became completely dry. In the long-term, only 5.7% of responders remained dry after medication was withdrawn. Children older than 9 years do better than those treated at an earlier age. A dose-response effect was apparent, and side-effects consisting of nasal stuffiness, headache, epistaxis, and abdominal pain were infrequent. No cases of water intoxication were reported. In one comparative study, patients treated by conditioning alarms had 10% fewer wet nights and a better long-term result. [1]

COMMENT. If we need to treat, alarms seem superior to drugs.