A comparison of the efficacy and tolerability of treating primary nocturnal enuresis with Solifenacin Plus Desmopressin, Tolterodine Plus Desmopressin, and Desmopressin alone: a randomized controlled clinical trial

Abstract

Introduction: Nocturnal enuresis (enuresis) is one of the most common developmental problems of childhood, which has often a familial basis, causes mental and psychological damage to the child and disrupts family solace. Objectives: In this study, we compared therapeutic effi cacy and tolerability of treating primary nocturnal enuresis (PNE) with solifenacin plus desmopressin, tolterodine plus desmopressin, and desmopressin alone. Because we don't have enough information about this comparison especially about solifenacin plus desmopressin. Patients and Methods: This clinical trial study was performed on 62 patients with enuresis aged 5-15 years who referred to the urology clinic of Imam Khomeini Hospital in Ahwaz in 2017-2018. Patients were randomly assigned to one of the three different therapeutic protocols and any participants were given a specifi c code. After that, we compared the therapeutic response and the level of satisfaction of each therapeutic group in different months. Data were analyzed using SPSS 22 software and descriptive and analytical statistics. Results: The mean age of patients was 8.70±66 years. In the therapeutic group with desmopressin and solifenacin, 19 of 20 patients (95%) achieved complete remission (1) after a 3-month treatment in comparison with monotherapy group in which 14 of 22 patients (63.63%) achieved complete remission; and in the combination therapy group of desmopressin and tolterodine, in the study and the evaluation of the consequences of 3-month treatment of this group, it was found that 17 of 20 patients (85%) had complete remission. Overall, the therapeutic response in combination therapy groups of desmopressin plus anticholinergic was higher than the monotherapy group of desmopressin alone. Conclusion: Our results demonstrate that the combination of desmopressin and an anticholinergic agent is highly effective in treatment of children with PMNE. Although desmopressin has long been a fi rst-line treatment for PMNE, desmopressin monotherapy often fails to achieve a successful response in patients with PMNE.

Clinical Study on the Treatment of Pediatric Primary Nocturnal Enuresis by Integrated Traditional Chinese and Western Medicine

“…The success rate of solifenacin for the treatment of NE varies from 10 % to 65 %. The CR rate of solifenacin in this study (30.0 %) was consistent with that of Ghanavati et al [4] , but lower than that of Fujinaga et al [9] . This difference may be related to short-term medication, efficacy standards and ethnic or sociocultural differences.…”

“…As a new generation of M-receptor blockers, solifenacin is commonly used in the treatment of overactive bladder. Studies have shown that, the application of low-dose solifenacin in pediatric PNE can effectively improve the curative effect and reduce recurrence [4] . At present, there have been some reports on the therapeutic effect of low-dose solifenacin in PNE [5] , but there are few reports on the therapeutic effect of solifenacin combined with suoquan capsules in children with PNE and further research is needed.…”

The pooled analysis evaluates the therapeutic efficacy of desmopressin combined with anticholinergic drugs in the treatment of pediatric nocturnal enuresis

“…Lastly, to ensure a flawless data set, we eliminated five papers that were inadvertently duplicated. Ultimately, our study comprised eight high‐quality RCTs 15,16,20–25 . The selection process is visually depicted in Figure 1, while Table 1 encapsulates the study and patient characteristics.…”

Association between winter season and desmopressin treatment efficiency in children with monosymptomatic nocturnal enuresis: a pilot study

“…After receiving oral desmopressin treatment, nearly one-third of children had no subsequent MNE episodes, one-third obtained partial relief, and one-third had no benefit (7). MNE cure rate can be improved by combination therapy strategies (8).…”