The Effect of Imipramine and Desmopressin on Sleep Arousal in Nocturnal Enuresis / 대한비뇨기과학회지

PURPOSE: High arousal threshold, nocturnal polyuria and small nocturnal functional bladder capacity have been implicated as causes of nocturnal enuresis. The two medications most widely used for the treatment of enuresis are imipramine and desmopressin. This study evaluated the effects of imipramine and desmopressin on sleep arousal. MATERIALS AND METHODS: A total of 50 enuretic patients who had responded to medications from Mar 1999 to Dec 2001 were evaluated. The mean age was 7 years old(range, 5-16), and there were 40 boys and 10 girls. They were classified into three groups according to their medication: imipramine group(22 patients), desmopressin group(7) and the combination group (imipramine+desmopressin, 21 patients). The parents were asked to record whether the patients woke up or not for 100 consecutive nights. RESULTS: The mean number of nights/100 nights that the patients woke up in each group was 3.2+/-7.2 in the imipramine group, 1.2+/-0.7 in the desmopressin group and 5.0+/-7.6 in the combination group. CONCLUSIONS: The main mechanism of imipramine and desmopressin for the treatment of enuresis does not seem to be associated with sleep arousal.

Bladder Stone Formation on Intra-uterine Contraceptive Device Perforated into the Bladder / 대한비뇨기과학회지

Various intravesical foreign bodies have been extracted from the bladder. Their introduction into the bladder may be through self-insertion, iatrogenic insertion or migration from the adjacent organs. The means of extracting the foreign bodies differ according to the nature and characteristics of the foreign bodies and to minimize bladder and urethral injury. However, complete extraction should also be confirmed after the extraction procedure. Bladder stone formation in an intra-uterine contraceptive device that perforates into the bladder seldom occurs. We experienced a case of a bladder stone that formed in an intra-uterine contraceptive device, which had perforated into the bladder. The possibility of an intravesical foreign body should be considered in any patient with chronic unexplained lower urinary tract symptoms.