Change of Urinary Nitrite Excretion in Primary Enuresis after Indomethacin Treatment

Abstract

Various treatment modalities have been used in primary Nocturnal Enuresis (PNE). Inhibition of prostaglandin synthesis may have value in the management of PNE. The effect of PGs on the urinary system are similar to those of Nitrous oxide (No), so there might be a link between No production and PNE. We can use nitrite as a good indicator of both PG and No because it is a stable metabolite of No. Our objective in this study was to assess urinary nitrite excretion in patients with enuresis and to evaluate the effect of indomethacin (a potent prostaglandin synthesis inhibitor) on urinary nitrite excretion. Sixty children participated in this study with age range 5-14 years and were divided into three groups: Group A comprised 20 children with PNE and were given 50 mg indomethacin suppositories each night for 1 month, group B comprised also 20 children with PNE not receiving treatment. Both groups were assessed by frequency of bed wetting episodes as well as by measuring urinary nitrites. In addition, 20 normal comparable controls were assessed as regards their urinary nitrites to show the difference in its values between enuretics and normal individuals. The results showed increase in nitric acid level in enuretic children than controls with marked decrease in its levels after receiving Indomethacin and marked improvement in the frequency of bed-wetting.