Comparison of effects of treatment of primary nocturnal enuresis with oxybutynin plus desmopressin, desmopressin alone or imipramine alone: a randomized controlled clinical trial.
OBJECTIVE
We prospectively evaluated the efficacy of a combination of desmopressin and oxybutynin for treating children with nocturnal enuresis, compared to the single drugs imipramine and desmopressin.


METHODS
We enrolled 158 patients from 2003 to 2004. Children were randomly assigned to 1 of 3 groups and treated with desmopressin, imipramine or a combination of desmopressin plus oxybutynin. Of these patients 145 (100 boys and 45 girls, mean age 7.8 +/- 2.5 years, range 5 to 15) were followed for more than 6 months. Efficacy was measured at 1, 3 and 6 months in terms of average enuretic frequency, 5-scale response based on change in nocturnal enuretic frequency after treatment and posttreatment enuretic frequency as a percentage of pretreatment baseline frequency. The latter efficacy was classified according to daytime voiding symptoms. Statistical evaluation was performed using chi-square tests and ANOVA.


RESULTS
Of the 145 children followed 48 received combination therapy, 49 received desmopressin and 48 received imipramine. A total of 68 patients (47%) had monosymptomatic enuresis and 77 (53%) had polysymptomatic enuresis. Combination therapy produced the best and most rapid results regardless of whether the children had monosymptomatic or polysymptomatic enuresis.


CONCLUSIONS
Combination therapy with desmopressin plus oxybutynin for the treatment of pediatric nocturnal enuresis was well tolerated, and gave significantly faster and more cost-effective results than single drug therapy using either desmopressin or imipramine.
Lee
Tack
T
Department of Urology, Inha University Medical College, Incheon, Korea.
Suh
Hong Jin
HJ
Lee
Hun Jae
HJ
Lee
Ji Eun
JE
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D004775:Enuresis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007099:Imipramine / Q000008:administration & dosage*; D008297:Male; D008333:Mandelic Acids / Q000008:administration & dosage*; D011379:Prognosis; D011446:Prospective Studies; D016896:Treatment Outcome; D014563:Urodynamics / Q000187:drug effects
D008333:Mandelic Acids; D003894:Deamino Arginine Vasopressin; C005419:oxybutynin; D007099:Imipramine