Hafiza Nuzhat, Imran Qadir, Muhammad Tahir Bashir Malik, Shazia Nazar.
Outcome Of Combination Therapy Versus Behavior Therapy In Treatment Of Nocturnal Enuresis.
J Uni Med Dent Coll Jan ;8(4):7-13.

OBJECTIVE: To compare the outcome of behavioral therapy alone and in combination with pharmacotherapy in management of NE. OPERATIONAL DEFINITION: Behavioral therapy was performed with prompted voiding (voiding by clock) at day time & reducing fluid intake at bedtime. Pharmacotherapy was performed with orally administered imipramine at bedtime. MATERIAL AND METHOD: STUDY DESIGN: Comparative study. SETTING: Urology department, Children Hospital, Faisalabad. SAMPLING: One hundred & thirty consecutive children in age range of 5-13 years with nocturnal enuresis were enrolled in the study and randomly allocated in two groups. One group was advised behavioral treatment alone and other was advised pharmacotherapy (imipramine) along with behavioral therapy.The children with known urinary tract pathologies/congenital anomalies, active urinary tract infection, acquired urologic disease, neurologic diseases and children with daytime LUTS were excluded from the study. Results: At first follow up (15-days), in group-A (behavioral therapy alone), 7.7% children reported complete resolution of NE, 23.1% showed improvement (reduction in episodes of NE) and 69.2% showed no improvement. At first follow up (15-days), in group-B (combination therapy), 15.4% children reported complete resolution of NE, 61.5% showed improvement (reduction in episodes of NE) and 23.1% showed no improvement. At second follow up (30-days), in group-A (behavioral therapy alone), 38.5% children reported complete resolution of NE, 38.5% showed improvement (reduction in episodes of NE) and 23% showed no improvement. At second follow up (30-days), in group-B (combination therapy), 38.5% children reported complete resolution of NE, 46.2% showed improvement (reduction in episodes of NE) and 15.4% showed no improvement. CONCLUSION: Behavioral therapy can be offered as an initial treatment step in management of nocturnal enuresis. However, combination therapy (behavioral +pharmacotherapy) gives an overall better outcome in the treatment of Nocturnal Enuresis as compared to behavioral therapy alone.

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