文档介绍：28The American ExperienceWith DesmopressinDavid A. Bloom, Professor SurgeryChief Pediatric UrologyUniversity MichiganAnn Arbor, MichiganAddress correspondence David Bloom, ., Associate Professor Surgery, Chief Urology,University Michigan, 1500 MedicalCenter Ann Arbor, MI 48109-0330Summary: Conclusive evidence of a polyuric etiology from a failure of vasopressinelevation led to a new pharmacologic approach to the treatment of childhood nocturnalenuresis. Desmopressin acetate, a vasopressin analogue, has been used essfully since1978 to treat this condition. Desmopressin’s efficacy at doses of 5 to 40 has beendemonstrated in Europe and the United States. Similarly, its safety has been established,and it is a first-line choice for physicians an integral,normal part of develop-ment in young children inwhom sleep duration may exceedbladder capacity and arousal mech-anisms may be immature. In fact,deferred nocturnal vasopressin am-plification probably an importantphysiologic device in young chil-dren, and physicians should gen-erally be reluctant to considernocturnal enuresis a conditionrequiring medical attention inchildren under 7 years of choices presentlyavailable for nocturnal enuresiscan be grouped into three catego-ries. The first actually no man-agement, ., waiting forspontaneous resolution, which islikely in m