Question of the Week

Question :
Posted On : 24 Jun 2023
Which is more effective in the treatment of nocturnal enuresis- Desmopressin plus alarm bed or Desmopressin plus Oxybutynin?
Expert Answer :
Monosymptomatic nocturnal enuresis, a heterogeneous condition, is frequently treated in children aged More than 5 years. Of the various treatment options, enuresis alarm has been widely advocated as being effective for treating nocturnal enuresis, while extracorporeal pelvic floor magnetic stimulation for overactive bladder, urge incontinence, and urgency-frequency syndrome has not yet been confirmed by controlled studies as primary treatment for monosymptomatic nocturnal enuresis. Desmopressin, an antidiuretic hormone {ADH} analog, or Arginine Vasopressin {AVP}, can resolve primary nocturnal enuresis by decreasing night-time urine production. Enuretic children requiring either Desmopressin or Desmopressin plus Oxybutynin to achieve dryness have polyuria. Tricyclic antidepressants {i.e. imipramine} are used successfully in enuretic children. Although tricyclics and Desmopressin are effective in reducing the number of wet nights, most children relapse after discontinuation of active treatment. Combined therapy {enuresis alarm, bladder training, motivational therapy, and pelvic floor muscle training} is more effective than each component alone or than pharmacotherapy. Furthermore, Desmopressin combined with alarm therapy has a positive effect on enuresis.
Answer Discussion :
Ismail Elmarasi
Desmopressin plus oxybutynin

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