Van Med J. 2025; 32(4): 260-264 | DOI: 10.5505/vmj.2025.47966

Comparison of Desmopressin Withdrawal Strategies on Relapse Rates in Children with Monosymptomatic Nocturnal Enuresis

Aykut Akinci¹, Murat Can Karaburun^2
1Department of Urology, Pamukkale University, Denizli, Turkey
²Department Of Urology, Etlik City Hospital, Ankara, Turkey

INTRODUCTION: Desmopressin is a common first-line treatment for monosymptomatic nocturnal enuresis (MNE), but relapse after cessation is frequent. The most effective withdrawal strategy remains unclear.
METHODS: This retrospective multicenter study included children with MNE who achieved full response to desmopressin. Patients were grouped based on withdrawal method: abrupt cessation, dose reduction, or time-extended tapering. Relapse was defined as more than one wet night per month within 12 weeks after stopping treatment. Relapse rates were compared among groups.
RESULTS: Among 286 children included, relapse occurred in 55.7% of those with abrupt cessation, 42.7% with dose reduction, and 38.7% with tapering (p = 0.039). Structured strategies resulted in significantly lower relapse rates.
DISCUSSION AND CONCLUSION: Gradual desmopressin withdrawal strategies, including dose reduction and tapering, are more effective than abrupt cessation in reducing relapse rates in children with MNE. These approaches may enhance long-term treatment success.

Keywords: Monosymptomatic nocturnal enuresis, desmopressin, relapse, withdrawal strategy

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