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Oxybutynin for treatment of nocturnal enuresis in children
Bat-Chen Friedman1, Boris Friedman, Ran D Goldman
1Pediatric Research in Emergency Therapeutics (PRETx) program, BC Children's Hospital, Vancouver, BC.
Insights
Oxybutynin is not proven effective for nighttime bed-wetting alone. It may be a second-line option for children with both daytime and nighttime wetting, but consider its side effects.
Area of Science:
- Pediatric Urology
- Pharmacology
Background:
- Nocturnal enuresis (NE) is common in children.
- Behavioral methods often fail for persistent NE.
- Medical treatment is sought when behavioral interventions are unsuccessful.
Purpose of the Study:
- To evaluate the safety and efficacy of oxybutynin for treating nocturnal enuresis in a 7-year-old child.
- To determine if oxybutynin is appropriate for primary treatment of isolated nighttime wetting.
Main Methods:
- Clinical case presentation of a child with isolated nocturnal enuresis.
- Review of oxybutynin's pharmacological profile and clinical evidence for NE treatment.
Main Results:
- Oxybutynin is an anticholinergic medication.
- Evidence does not support oxybutynin's efficacy for NE without daytime symptoms.
- Oxybutynin may be effective as a second-line treatment for combined daytime and nighttime wetting.
Conclusions:
- Oxybutynin is not recommended as a first-line treatment for isolated nocturnal enuresis.
- Potential central nervous system adverse effects necessitate careful consideration, particularly in young children.
- Its use should be reserved for cases with documented daytime symptoms alongside nighttime wetting.
Question:
A 7-year-old child and his parents visit my clinic owing to the child's frequent bed-wetting. During the day, he has no problem controlling his urination. The family has tried behavioural methods but has failed to achieve dryness during the night. They ask to begin medical treatment. Is oxybutynin a safe and effective drug for treating nocturnal enuresis?
Answer:
Oxybutynin is an anticholinergic drug that has not been proven to be effective for treatment of nocturnal enuresis not accompanied by daytime symptoms, such as urgency. It can be added as a second-line drug and is effective for treating children with both daytime and nighttime wetting. Nevertheless, its common adverse effects, which can involve the central nervous system, should be considered when deciding whether or not to use it, especially in young children.
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