Oxybutinin-desmopressin association in the treatment of primary nocturnal enuresis with diurnal urination disorders]

BACKGROUND: Since most of the children observed in our Centre present enuresis with voiding disturbance, we carried out a study where these patients were treated with the DDAVP + Oxybutinin association. METHODS: We have treated 89 children with enuresis and voiding disturbances (urge incontinence, voiding urgency, urinated > 7 times a day), administering a drugs combination of desmopressin (20 micrograms/daily) and oxybutinin (0.3-0.6 mg/kg/bid or tid) for a variable period, depending on response to the treatment. RESULTS: The results demonstrate the efficacy of this association: we have observed a reduction in average bed wetting nights from 23.4 nights/month to 6.4 wet nights after 1 month, to 3.8 ad 2.9 respectively after 3 and 6 months from the beginning. Moreover we obtained a recovery of all daily voiding disturbances after 3 months. Fifty percent of children were cured after 4 months of therapy and finally 93.2% recovered at 6 months. On the other hand, 2 children were no-responders to the therapy even after 9 months of combined drugs administration. CONCLUSIONS: Based on these results we can affirm that children with nocturnal enuresis and voiding disturbance can be treated with this combined therapy. Actually, the reduction of urinary output and thus lower bladder filling, due to the desmopressin, decreases the onset of uninhibited bladder contractions and enhances oxybutinin activity.