Use of propranolol in children with primary nocturnal enuresis

In nocturnal enuresis, motivational therapy, alarm therapy, and drug therapy, such as anticholinergics, imipramine, and sertraline, are the mainstay of treatment. In the present study, we used motivational therapy, oxybutynin, and propranolol in children with primary nocturnal enuresis to determine if propranolol is an effective treatment. Fifty-two children with primary nocturnal enuresis were included in the study. Firstly, motivational therapy was given for 1 month to all patients. Patients who failed the motivational therapy were randomly given oxybutynin or propranolol. The patients were re-evaluated after 1 month of drug therapy. There was not a significant difference between oxybutynin and propranolol groups for initial frequency of nocturnal enuresis ( p > 0.05). Of 52 patients, 28 (53.8%) patients improved by motivational therapy. There were 14 patients in the oxybutynin group. One patient was excluded from the study because facial flushing and mouth drying developed in the first week of oxybutynin therapy. In oxybutynin group, 12 of 13 (92.3%) patients improved. There were 10 patients in the propranolol group. In the propranolol group, while nine (90%) patients did not improve, one patient had significant remission (90%, p < 0.001). No significant adverse reaction was noted during propranolol therapy. There was no significant difference between oxybutynin and propranolol groups for initial frequency of nocturnal enuresis (p > 0.05). A significant difference was found between the groups for the remission of nocturnal enuresis ( p < 0.001). Our findings showed that motivational therapy is the first line treatment in primary nocturnal enuresis, and oxybutynin but not propranolol is effective in patients who failed with the motivational therapy.