Comparative Response of Desmopressin Versus Combination Therapy (Desmopressin + Oxybutynin) in Children with Nocturnal Enuresis

Abstract

BACKGROUND: One of the most common conditions in children is nocturnal urinary incontinence. Use of desmopressin alone or in combination therapy with oxybutynin has been a major effect in alleviating nocturnal enuresis. OBJECTIVE: To assess the safety as well as efficacy of desmopressin monotherapy alone and in combination (desmopressin + oxybutynin) in treating nocturnal urinary incontinence among children with 7 to 13 years. MATERIALS AND METHODS: This double blind experimental study has been carried out in National Institute of Child Health with the utilization of convenient sampling technique. Data has been collected after taking ethical approval and informed consent of the Parents with complete confidentiality. The sample size was 84 and equal number of patients was divided in two groups. Group 1 was given desmopressin at monotherapy at a dose of 0.2 mg and Group 2 was given desmopressin and oxybutynin at the dose of 0.2 mg desmopressin and 5 mg oxybutynin patients were diagnosed on the basis of history. Routine lab investigation included Urine DR and ultrasound abdomen, PNE patients were selected in this study. Each patient has been followed at the end of 1st, 2nd and 3rd month. After recoding the demographic variables, the improvement of each patient has been assessed on the basis of complete, partial and no recovery. Statistical analysis has been done through the software version 23.0 of SPSS. Quantifiable data was represented as mean and standard deviation. Qualitative data has been reported as frequency and percentage. Independent t-test has been applied to assess the mean difference. Chi-square test was used to assess association with p-value <0.05 as the significant level. RESULTS: In this study significant differences between two groups were found with respective to socio economic status, lack of education of parents (P Less than 0.05). The frequency, urgency and incontinence of this ailment was significantly controlled by combination therapy ((desmopressin + oxybutynin) as compared to desmopressin as monotherapy (P 2 Less than 0.05) as patient was followed after 1, 2, 3 monthly basis. The side effects were also less with combination therapy. CONCLUSION: It was concluded in our study that desmopressin combination with oxybutynin is more effective as compared to monotherapy treatment. The affectivity of the combination therapy was very high with least side effects and all the children recovered from the condition at third month of treatment. Furthermore, headache was observed to be common with monotherapy and loss of appetite was observed with combination therapy