title: Desmopressin, Imipramine, and Oxybutynin in the Treatment of Primary Nocturnal Enuresis: A Randomized Clinical Trial.
abstract: BACKGROUND
  Nocturnal enuresis is the most common pediatric urologic problem in outpatient clinics.
  
  
  OBJECTIVE
  To assess the effect of various monotherapies, and comparing the effects of desmopressin, imipramine, and oxybutynin in children with enuresis, as well as the influence of socioeconomic and cultural factors of their families on the response and relapse rates.
  
  
  METHODS
  The study was a randomized clinical trial conducted on 92 children aged 5 - 14 years, referred to the pediatric clinic of Semnan University Hospital in Semnan, Iran. Children with primary nocturnal enuresis were randomly allocated to three different treatment groups: desmopressin (n = 30), imipramine (n = 31), and oxybutynin (n = 31) all for 6 weeks. The socioeconomic and demographic characteristics of all participants were recorded. The number of wet nights per week was noted at the end of the 6-week-trial, and children were followed up to three months for relapse.
  
  
  RESULTS
  Children in the oxybutynin group showed a slightly higher response rate (71.0% success) and a lower relapse rate (31.8%), while in the desmopressin group the response and relapse rates were 63.3% and 57.9%, respectively, and in the imipramine group 61.3% and 63.2%, respectively. However, the difference between the 3 groups in terms of response (P = 0.701) and relapse rates (P = 0.095) was not statistically significant.
  
  
  CONCLUSIONS
  There is no significant difference between monotherapy with desmopressin, imipramine or oxybutynin in children with enuresis. However, oxybutynin showed a higher response rate and a lower relapse rate compared to other medications. More clinical trials with a larger sample size are needed to clarify these uncertainties.
authors.affiliation: Department of Pediatrics, Semnan University of Medical Sciences, Semnan, IR Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Seyfhashemi
authors.affiliation: Research Centre for Social Determinants of Health , Department of Community Medicine, Semnan University of Medical Sciences, Semnan, IR Iran.
authors.forename: Raheb
authors.initials: R
authors.lastname: Ghorbani
authors.affiliation: Department of Pediatrics, Semnan University of Medical Sciences, Semnan, IR Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Zolfaghari
keywords: Desmopressin; Imipramine; Nocturnal Enuresis; Oxybutynin