Desmopressin versus Oxybutynin for Nocturnal Enuresis in Children in Bandar Abbas
A Randomized Clinical Trial
Keywords:
Oxybutynin, Desmopressin, nocturnal enuresisAbstract
Background: Nocturnal enuresis is among the most common disorders in children. Several pharmacological and non-pharmacological treatments are available for nocturnal enuresis. Studies for reaching the best pharmacological treatment for this disorder are continuing.
Objective: To compare the effectiveness and safety of Desmopressin and oxybutynin for treatment of nocturnal enuresis in children from Bandar Abbas in 2014.
Methods: This randomized controlled trial was conducted in 2014 and participants included 66 children with nocturnal enuresis who were more than 5 years old. Patients were randomly assigned into two groups. The first group received 120 microgram Desmopressin daily for 2 months, then 60 microgram daily for 2 months, then 60 microgram every 2 days. The second group received 5 mg oxybutynin twice a day for 6 months. The patients were followed after 1, 3, and 6 months to track treatment response. The study outcomes were frequency of nocturnal enuresis, urinary incontinency, urgency, and frequency. Data were analyzed using SPSS software.
Results: There were no significant differences between the two groups with respects to sex, age, place of residence, and parents’ education (p<0.05). Nocturnal enuresis, incontinency, urgency, and frequency of nocturnal enuresis was significantly lower with Desmopressin treatment in comparison to the oxybutynin treated group after 1 and 3 months (p<0.05). In addition, constipation and xerostomia were more frequent among the oxybutynin group after 1, 3, and 6 months (p<0.01). Blurred vision was also more frequent among oxybutynin group after 3 months (p<0.01). After 6 months the frequency of nocturnal enuresis and its frequency was higher in oxybutynin group in comparison to the Desmopressin group (p<0.05).
Conclusion: Desmopressin is more effective and has lower rate of side effects in comparison to oxybutynin for treatment of nocturnal enuresis. We recommend using Desmopressin for treatment of nocturnal enuresis in children. More studies are needed to achieve the best pharmacological treatment option for treatment of nocturnal enuresis.
Trial registration: The trial is registered at ClinicalTrials.gov with a ClinicalTrials.gov Identifier: NCT02538302
Funding: The funder of this research is Hormozgan University of Medical Sciences.
References
Miller K, Klauber GT. Desmopressin acetate in children with severe primary nocturnal enuresis. Clin Ther.
; 12(4): 357-66. PMID: 2224950.
Marschall-Kehrel D, Harms TW, Enuresis Algorithm of Marschall Survey G. Structured desmopressin
withdrawal improves response and treatment outcome for monosymptomatic enuretic children. J Urol.
; 182(4 Suppl): 2022-6. doi: 10.1016/j.juro.2009.03.068. PMID: 19695616.
Lose G, Lalos O, Freeman RM, van Kerrebroeck P, Nocturia Study Group. Efficacy of desmopressin
(Minirin) in the treatment of nocturia: a double-blind placebo-controlled study in women. Am J Obstet
Gynecol. 2003; 189(4): 1106-13. PMID: 14586363.
Friedman BC, Friedman B, Goldman RD. Oxybutynin for treatment of nocturnal enuresis in children. Can
Fam Physician. 2011; 57(5): 559-61. PMID: 21642736, PMCID: 3093588.
Montaldo P, Tafuro L, Rea M, Narciso V, Iossa AC, Del Gado R. Desmopressin and oxybutynin in
monosymptomatic nocturnal enuresis: a randomized, double-blind, placebo-controlled trial and an
assessment of predictive factors. BJU Int. 2012; 110(8 Pt B): E381-6. doi: 10.1111/j.1464- 410X.2011.10918.x. PMID: 22313792
Caione P, Arena F, Biraghi M, Cigna RM, Chendi D, Chiozza ML, et al. Nocturnal enuresis and daytime
wetting: a multicentric trial with oxybutynin and desmopressin. Eur Urol. 1997; 31(4): 459-63. PMID:
Persson-Junemann C, Seemann O, Kohrmann KU, Junemann KP, Alken P. Comparison of urodynamic
findings and response to oxybutynin in nocturnal enuresis. Eur Urol. 1993; 24(1): 92-6. PMID: 8365449.
Varan B, Saatci U, Ozen S, Bakkaloglu A, Besbas N. Efficacy of oxybutynin, pseudoephedrine and
indomethacin in the treatment of primary nocturnal enuresis. Turk J Pediatr. 1996; 38(2): 155-9. doi:
PMID: 8701478.
Lee T, Suh HJ, Lee HJ, Lee JE. Comparison of effects of treatment of primary nocturnal enuresis with
oxybutynin plus desmopressin, desmopressin alone or imipramine alone: a randomized controlled clinical
trial. J Urol. 2005; 174(3): 1084-7. PMID: 16094064.
Deshpande AV, Caldwell PH, Sureshkumar P. Drugs for nocturnal enuresis in children (other than
desmopressin and tricyclics). Cochrane Database Syst Rev. 2012; 12: CD002238. doi:
1002/14651858.CD002238.pub2. PMID: 23235587.
Cho SY, Lee KS, Kim JH, Seo JT, Choo MS, Kim JC, et al. Effect of combined systematized behavioral
modification education program with desmopressin in patients with nocturia: a prospective, multicenter,
randomized, and parallel study. Int Neurourol J. 2014; 18(4): 213-20. doi: 10.5213/inj.2014.18.4.213.
PMID: 25558419, PMCID: 4280441.
Ahmed AF, Amin MM, Ali MM, Shalaby EA. Efficacy of an enuresis alarm, desmopressin, and
combination therapy in the treatment of saudi children with primary monosymptomatic nocturnal enuresis.
Korean J Urol. 2013; 54(11): 783-90. doi: 10.4111/kju.2013.54.11.783. PMID: 24255762, PMCID:
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