MP70-01 MANAGEMENT OF THE REFRACTORY NOCTURNAL ENURESIS PATIENT TO DESMOPRESSIN IN A PEDIATRIC POPULATION: DESMOPRESSIN + OXYBUTYNIN VS. DESMOPRESSIN + IMIPRAMINE

You have accessJournal of UrologyCME1 Apr 2023MP70-01 MANAGEMENT OF THE REFRACTORY NOCTURNAL ENURESIS PATIENT TO DESMOPRESSIN IN A PEDIATRIC POPULATION: DESMOPRESSIN + OXYBUTYNIN VS. DESMOPRESSIN + IMIPRAMINE Spencer Shain, Jordan Gitlin, Amelia Pantazis, Ronnie Fine, Mark Horowitz, Steven Friedman, Paul Zelkovic, Lori Dyer, Richard Schlussel, Jamie Freyle, Alexander Fang, Jessica Sommer, and Israel Franco Spencer ShainSpencer Shain More articles by this author , Jordan GitlinJordan Gitlin More articles by this author , Amelia PantazisAmelia Pantazis More articles by this author , Ronnie FineRonnie Fine More articles by this author , Mark HorowitzMark Horowitz More articles by this author , Steven FriedmanSteven Friedman More articles by this author , Paul ZelkovicPaul Zelkovic More articles by this author , Lori DyerLori Dyer More articles by this author , Richard SchlusselRichard Schlussel More articles by this author , Jamie FreyleJamie Freyle More articles by this author , Alexander FangAlexander Fang More articles by this author , Jessica SommerJessica Sommer More articles by this author , and Israel FrancoIsrael Franco More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003338.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Desmopressin (DDAVP) is well accepted as first-line medical therapy for nocturnal enuresis (NE). If DDAVP is ineffective, combination therapy of DDAVP+oxybutynin (Oxy) or DDAVP+imipramine (Imp) has been used. This study assessed the efficacy of adjunct therapy with either Imp or Oxy in the management of NE patients who failed DDAVP treatment. METHODS: A retrospective chart review of our database for patients with NE was performed. All patients who were prescribed DDAVP, Oxy, and Imp over 14 years for NE were included. Two cohorts of patients were examined; group A was treated with DDAVP and Oxy, and group B was treated with DDAVP and Imp. Pretreatment measurement of Vancouver Symptom Score (VSS) was used to compare groups as well as the VSS question “I wet my bed at night” with 4: I wet my bed every night, 3: 4-5 nights per week, 2: 1-2 nights per week, 1: 3-4 nights per month, and 0: never. ICCS criteria for continence success was utilized to determine outcomes. Statistical analysis was performed with SPSS. RESULTS: 2521 patients were identified who were prescribed one of the 3 medications. 72 patients with a mean age of 9.8±2.8 years were identified, of which 48 were male and 24 female. Of these patients, 58 were prescribed both DDAVP and Imp (group B), 23 DDAVP and Oxy (group A), and 9 transitioned from group A to group B. Mean pretreatment VSS showed no difference between the groups. Both groups had minimal drops in wet nights with DDAVP alone. When comparing groups, it was found that group B reduced wet nights significantly more than group A (VSS wet night score 0.7 vs 2.3 respectively). Complete response rate was 68% vs 5% (OR=42.5, p<0.001) (Imp vs Oxy respectively). CONCLUSIONS: A combination of DDAVP and Imp was more effective in reducing wet nights and had a complete response rate that was 42.5 times greater than DDAVP and oxybutynin. Source of Funding: None. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1003 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Spencer Shain More articles by this author Jordan Gitlin More articles by this author Amelia Pantazis More articles by this author Ronnie Fine More articles by this author Mark Horowitz More articles by this author Steven Friedman More articles by this author Paul Zelkovic More articles by this author Lori Dyer More articles by this author Richard Schlussel More articles by this author Jamie Freyle More articles by this author Alexander Fang More articles by this author Jessica Sommer More articles by this author Israel Franco More articles by this author Expand All Advertisement PDF downloadLoading ...