What is cost of DDVAP?

DDAVP is not a cheap medication. The smallest dose (5 ml) costs anywhere from $130-$180. Thirty ml of DDAVP costs over $800. Some insurance companies do cover the cost.

While DDAVP is a great drug, it does not work in everyone. So before you start spending your mortgage money on a medication that may not work, try and speak to your doctor or even the drug company representative to see if you can get some samples. If the medication does not work in 5-7 days, it is unlikely to work at all

Does DDVAP work for bedwetting?

DDAVP is very effective in stopping night time bed wetting and is an excellent choice when one is going for a trip or to sleep over at friend’s house.

Most parents report that DDAVP immediately decreases enuresis in their child. The drug only decreases the frequency of bed wetting but does not cure the problem. Most health care professionals recommend that after a period of 1-2 months, the dose of DDAVP should be slowly decreased. However, most data indicate that relapse of enuresis is quite common when the drug is stopped or the dosage is decreased. This cycle of re-starting and tapering DDAVP usually goes on for months, before one can finally stop the drug.

Unfortunately, in some children DDAVP is required to control bed wetting for many months. In such cases, a few parents tolerate some degree of bed wetting and stop the drug cold turkey.

To ensure that DDAVP works, it is important not to give the child any fluids before bedtime. Current data indicate that DDAVP works in about 60-80 percent of children with primary enuresis. There are limited data on DDAVP in adults but the success rate is very low.

What are side effects of DDVAP when I use it for urinary incontinence?

The side effects of DDAVP include nose bleeds, headaches and abdominal bloating. These side effects are not common but do occur in about 1-3% of children. Most of these side effects are well tolerated.

What is the best method of using DDAVP for bedwetting?

DDVAP is obtainable as a nasal spray but it is currently under FDA restriction and not recommended for use in the treatment of primary enuresis.

DDAVP pill is usually taken at the lowest dose just before bed time. The dose is gradually increased every 3-4 days until the desired response is obtained. The oral pill is placed underneath the tongue where it usually dissolves very fast. One should not take the pill with a glass of water. Water should be limited at night as one is trying to prevent excess urine formation.

I have a bed wetting problem and my colleagues say I should try DDAVP. Can you tell me a little bit about DDVAP?

Bedwetting is not a life threatening disorder but can create havoc in the life of an individual. In most cases, children who have a bed wetting problem grow out of it with time. Some children may improve with the use of an enuresis alarm. However, in other cases, the problem of bed wetting can be severe and may warrant medications. One of the best medication to treat bed wetting today is DDAVP or desmopressin. DDAVP is actually a synthetic hormone and is very effective in the treatment of enuresis.

DDAVP is available both as a pill and as a nasal spray. It works by reducing the amount of urine produced at night. With less urine formed, the bladder remains less full and the urge to urinate disappears. DDAVP is generally used in children after all conservative approaches have been tried and failed.

Removing tonsils for bed-wetting! Part 2

Unlike previous studies, this study was more rigidly controlled and all the children who underwent tonsillectomy for breathing problems were asked about their urinary problems. Also included in the study were children who underwent other types of surgery. 

The study showed that after 6 months, more than 50% of children remained dry, irrespective of the type of surgery.

Said Dr. Richard Rosenfeld of the American Academy of Otolaryngology-Head and Neck Surgery, "If your reason for doing the surgery is bedwetting, maybe give them six months, and see if they've improved."

However, the Doctor Rosenfeld added that this still does not rule out tonsillectomy and its role in bed-wetting. He went on to add that tonsillectomy mostly helps children with recent onset bed-wetting. He did not answer if he would recommend tonsillectomy for his children if they had bed-wetting!

So what should consumers do with children who have bed-wetting problems?

First, tonsillectomy is surgery and like any surgery has its fair share of complications. Tonsillectomy also costs thousands of dollars and then there is at least 1 week of recovery time.

 
Bed-wetting is a medical problem not surgical problem. The unethical surgeons claim that inflamed tonsils release substance(s) that cause urination, but there is no scientific proof for this belief. Moreover, when children with bed-wetting are evaluated, less than 10% have tonsillitis or enlarged tonsils. In addition, even after removing tonsils, more than 90% of children continue to have bed-wetting. Therefore, the first thing parents should do is avoid surgeons who want to remove tonsils as a treatment for bed-wetting. Instead, parents may want to try medications that may relax the bladder. Secondly, there are also bed-wetting alarms that may help wake up the child. 

Ultimately, the majority of children with bed-wetting simply grow out of the habit. On the other hand, after an unnecessary tonsillectomy you can even die.

Removing tonsils for bed-wetting! Part 1

For many years, some surgeons have been removing tonsils to cure bedwetting in children. Even though there is little correlation between the tonsils (which are located in the mouth) and the bladder (which is located into the lower abdomen), some surgeons actually believe that removing the tonsils actually diminishes bedwetting. Despite the lack of any good randomized studies, this practice is still common. Part of the reason is that some unscrupulous doctors are just interested in making money by performing unnecessary tonsillectomy and could not care less about bladder incontinence. 

Now there is evidence that having the tonsils taken out does not make the child any drier at night.

In this latest study, doctors discovered that removing the tonsils did stop bed wetting 6 months later, but so did all the other kids who had other unrelated surgeries like hernia repair

Says Dr Carmin Kalorin, a Urologist in North Carolina, “Given these results, we don't recommend tonsillectomy as a treatment for bedwetting."

Bed-wetting is a serious issue and affects at least 15 percent of five year olds, but these numbers are grossly underestimated as not all families report this problem.

There are many causes for bed-wetting in this age group like having a small bladder, excess urine production at night, drinking fluids late at night or just being lazy and not getting out of bed to pee. Sometimes the nerve signals from the bladder to the brain are not working.

 
In very rare cases, bed-wetting may also occur in people who have trouble breathing at night. It appears that the difficulty in breathing triggers release of hormones that increase urine production. In children one common reason for the upper airway obstruction are enlarged tonsils. Thus, based on this hypothesis, researchers removed tonsils to determine if bed-wetting would cease.