A Comparative Study Between Imipramine , Oxybutynin and Non Drug Therapy in Treating Nocturnal Enuresis


ABSTRACT:BACKGROUND:Treatment with tricyclic antidepressants agents is the mainly used therapy for nocturnal enuresis also there are other agents such as anticholinergic drugs and desmopressin (nasal spray and oral) which are used to lesser extent also other modalities are used such as behavior modification.OBJECTIVE:We prospectively evaluated the effect of imipramine for treating children with nocturnal enuresis compared to oxybutynin and to non drug treatment.METHODS:We enrolled 149 patients of the age group more than 5 years from September 2006 to end of July 2007. The children were randomly assigned into three groups; the first (60 patients) treated with imipramine, the second (60 patients) treated with oxybutynin and the third (29 patients) treated with non drug therapy and the three groups were followed for more than 3 months. Treatment response was measured monthly for 3-6 months in terms of frequency of enuresis, tolerance to drugs and side effects of the drugs used . The recurrence of enuresis after stopping the treatment was also reported.RESULT:Of the 149 children followed 96(64.45%) were boys and 53(35.55%) were girls with 1.8:1 male to female ratio. Of those treated with imipramine 32 (53.34%) have complete dryness and 16 (26.66%) improved; while those treated with oxybutynin20 (33.3%) were dry and 20 (33.3%) improved. For those with non drug treatment 5 (17.2%) dry 14 (48.3%) improved and 10(34.5%) with no response.CONCLUSION:Treatment of nocturnal enuresis in children with imipramine was well tolerated and gave significantly faster and more cost-effective results than oxybutynin or non drug treatment, females had a significantly better response (P<0.05) than males in general.