Положительное влияние десмопрессина (адиуретина СД) на проявления нейрогенной дисфункции мочевого пузыря

Abstract

The neurogenic bladder is associated with different kinds of neurological disorders. One of the typical symptoms of the neurogenic bladder isnocturnal enuresis. It has been shown recently that one of enuresis' important mechanisms is an impaired 24-hour rhythm of antidiuretic hormone (arginine vasopressin, AVP) release. The decrease in AVP secretion at nighttime causes an increase in nocturnal diuresis that is associated with enuresis under conditions of bladder neurogenic dysfunction. This hypothesis led to trials of the AVP analogue DDAVP (Desmopressin, Adiuretin CD) upon children with noc turnal diuresis. The aim of this study was to estimate the effect of Adiuretin CD (Desmopressin, production of Ferring Co) on the neurogenic bladder. 12 children aged eight to 14 suffering from nocturnal diuresis were observed. To control the effects of Adiuretin CD, the frequencies of emptying and effective bladder volume were measured. In the majority of children, urofloumetry and retrograde cystometry in supine and up-right positions were tested using the domestic system ""Reljef." The initial dosage of 2-3 intranasal drops of Adiuretin CD was gradually increased to maximal level of 6-7 drops depending on the effectivity of the treatment. Enuresis stopped in 10 out of 12 children. The other symptoms of the neurogenic bladder disappeared in all of the children. In this way, our data confirms the pathogenic role of impaired AVP secretion in nocturnal enuresis, at least in certain cases. We suggest that the investigation of Adiuretin CD effects on symptoms of the neurogenic bladder should be continued."