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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author 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
author_facet 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
author_sort Melissa Faria Dutra
collection DOAJ
description 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.
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spelling doaj-art-5644be3aacd24f19a6cbb696f2ecfb572025-08-20T03:47:16ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-61192025-08-0151510.1590/s1677-5538.ibju.2025.0093Parasacral Transcutaneous Electrical Nerve Stimulation with Desmopressin Acetate for Treating Primary Monosymptomatic Enuresis: A Randomized Controlled Clinical TrialMelissa Faria DutraEleonora Moreira LimaJosé Murillo Bastos NettoLidyanne Ilídia da Silva de PaulaJosé de Bessa JúniorAmanda Lima Alves PereiraGlaúcia Cristina Medeiros DiasMônica Maria de Almeida VasconcelosFlávia Cristina de Carvalho Mradhttps://orcid.org/0000-0001-5484-2252ABSTRACT 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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382025000500402&lng=en&tlng=enEnuresisTranscutaneous Electric Nerve StimulationRandomized Controlled Trials as Topic
spellingShingle 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
Parasacral Transcutaneous Electrical Nerve Stimulation with Desmopressin Acetate for Treating Primary Monosymptomatic Enuresis: A Randomized Controlled Clinical Trial
International Brazilian Journal of Urology
Enuresis
Transcutaneous Electric Nerve Stimulation
Randomized Controlled Trials as Topic
title Parasacral Transcutaneous Electrical Nerve Stimulation with Desmopressin Acetate for Treating Primary Monosymptomatic Enuresis: A Randomized Controlled Clinical Trial
title_full Parasacral Transcutaneous Electrical Nerve Stimulation with Desmopressin Acetate for Treating Primary Monosymptomatic Enuresis: A Randomized Controlled Clinical Trial
title_fullStr Parasacral Transcutaneous Electrical Nerve Stimulation with Desmopressin Acetate for Treating Primary Monosymptomatic Enuresis: A Randomized Controlled Clinical Trial
title_full_unstemmed Parasacral Transcutaneous Electrical Nerve Stimulation with Desmopressin Acetate for Treating Primary Monosymptomatic Enuresis: A Randomized Controlled Clinical Trial
title_short Parasacral Transcutaneous Electrical Nerve Stimulation with Desmopressin Acetate for Treating Primary Monosymptomatic Enuresis: A Randomized Controlled Clinical Trial
title_sort parasacral transcutaneous electrical nerve stimulation with desmopressin acetate for treating primary monosymptomatic enuresis a randomized controlled clinical trial
topic Enuresis
Transcutaneous Electric Nerve Stimulation
Randomized Controlled Trials as Topic
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382025000500402&lng=en&tlng=en
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