چكيده لاتين :
Background: Primary nocturnal enuresis is a common disorder
that often leads to considerable distress in affected children
and their family. In many countries pharmacologic therapy
is preferred to non-pharmacologic behavioral and conditional
alarm therapy. Imipramine, oxybutynin, and desmo pressin
have been used for enuresis with various efficacies.
The aim of the present study was to compare the efficacy of
imipramine, oxybutynin , and combined imipramine and oxybutynin
in enuretic children aged 6-14 years old.
Methods: In a randomized controlled study 89 primary enuretic
children who were otherwise normal were allocated to three
groups: group A (imipramine users, n=29), group B (oxybutynin
users, n=26), and group C (combined imipramine and oxybutynin
users, n=34). The number of wet nights per week during control
period (2 weeks prior treatment), and treatment period (I month)
were compared in each group and inter groups. Also the cure rate
in the treatment period and the relapse rate in the follow up period
(I month) were compared between the three groups.
Results: The mean ages in groups A, B, and C were 7.9± 1.1 years,
8.2± 1.6 years, and 8.2±IA years respectively. There was no significant
difference in the mean ages in the three groups (P=0. 53).
In each group the mean number of wet nights per week decreased
durin g treatment period compared with pretreatment
period . This redu ction was s tatistica lly s ignificant (P<0.001 in
eac h group). Efficacy o f treatmen t betw een the three groups
was compared . There was si gnificant difference betw een them
(P<0 .001), but there was no s ignificant difference between
group A, and group B (P=0.56). The cure rate during treatment
period was 13.7%, 23%, and 4 1% in groups A, B, and C
respectively . Thi s difference was statistica lly s ignificant
(P=0.04). The relapse rate dur ing follow up period in groups
A, B, and C was 58.6%, 42.3% and 20.5% respe ct ively, revea
ling statistica l s ignificance (P=0.008) No sig nificant adver
se effects for the medications were observed .
Conclusion: Our findings suggest that combined umprarmne
and oxybutynin for primary enuresis is more effective than
eith er drug used alone. The combined therapy is recommended
in enuretic children who are non-responsive to
imipramine or oxybutynin alone.
