In the management of nocturnal enuresis, which medication is often considered after conservative measures fail?

Desmopressin is a synthetic analog of vasopressin (also known as antidiuretic hormone) and is commonly used in the management of nocturnal enuresis after conservative measures have proven ineffective. This medication works by reducing the amount of urine produced during the night, thereby decreasing the frequency of bedwetting episodes. It is particularly beneficial for children who tend to produce large volumes of urine during the night.

Desmopressin can help improve the situation for children experiencing nocturnal enuresis by making the bladder more manageable overnight, leading to a significant reduction in episodes. It is typically a well-tolerated medication and has been shown to be effective in a large population of children suffering from this condition.

While other medications like imipramine, oxybutynin, and fluoxetine have also been used in specific cases of enuresis, desmopressin is generally preferred due to its targeted mechanism of action. Imipramine is an antidepressant that has anticholinergic and sedative effects, and its use is less common now because of potential side effects. Oxybutynin is an anticholinergic agent that can help with bladder control issues, but it is not primarily indicated