Akhtar Firdous, Aqdus Bashir, Irfan Akhtar.
Management of Primary Nocturnal Enuresis in Children.
J Rawal Med Coll Jan ;6(2):52-6.

Background: A prospective, randomized trial carried out on paediatric out-patients with nocturnal enuresis to assess the efficacy of DDAVP (desmopressin), anticholinergics, tricyclic anti-depressants and nonpharmacologic interventions on nocturnal enuresis. Methods: 300 patients were studied during the 6 year period from June 1996 to June 2002 at Fauji Foundation Hospital, Hearts International Hospital and Islamic International Medical College / Railway Hospital, Rawalpindi. The age of patients ranged from 6 to 16 years. Children were randomized to receive drug, nonpharmacologic intervention or both. Results: Dry bed therapy combined with alarm was found to be most effective interventional therapy with cure in 70%. The next effective intervention was drugs of which DDAVP. Imipramine and Oxybutynin cured the condition in 60%, 45.56% and 38.70% respectively. Motivational therapy had a 26.20% cure rate while dry bed therapy and bladder control exercises alleviated the condition in 59.75%. Relapse was lowest for combination of dry bed and alarm therapy that is 7% while combination of dry bed training and bladder exercises, DDAVP, Imipramine, Oxybutynin and motivational therapy caused relapse in 20%, 20%, 35.40%. 32.01% and 31.37% patients respectively. Sixty patients with recurrence were subjected to combination therapy. A combination of DDAVP with alarm proved more effective with cure in 83.80% and relapse in 6.5% while 2 drug combinations of DDAVP and Imipramine was less effective with cure in 53.330/ and relapse in 20% children. Conclusions: Most effective treatment for enuresis is a combination of a drug as DDAVP with an Alarm which provides the benefit of medication which acts quickly and the alarm which has long term effectiveness.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com