Abstract

ABSTRACT:
BACKGROUND:
Nocturnal enuresis presents a common medical problem all over the world, over many years various therapeutic options have been tried; none was proved to be superior, because the defect occurs at many levels in the urinary tract and its neuronal control. Nowadays prostaglandins have been proved to play a role at renal, bladder, urethral and sympathetic control of urinary system.
OBJECTIVE:
We evaluated the role of diclofenac sodium when added to the conventional imipramine therapy in treating patients with primary nocturnal enuresis.
PATIENTS AND METHOD:
70 children complaining of nocturnal enuresis were enrolled in this study, half of them were given imipramine alone and the other half were given a combination of imipramine and diclofenac sodium at night before retiring to bed, and the number of wet nights per week was recorded on a calendar sheet by the parents over 4 weeks, those who showed more than 50% reduction in the number of wet nights a week were regarded as responders, who were followed after cessation of treatment over another 6 weeks to look for relapse.
RESULTS:
Of the patients treated with imipramine alone 57.14% (20/35) showed more than 50% decrease in the number of wet nights weekly compared to those treated by imipramine and diclofenac sodium who showed 84.84% (28/33) response rate (> 2.5 SE of difference between responding proportions). The relapse rate after stopping treatment was 60% (12/20) in the first group compared to 32.1% (9/28) which exactly two times the SE of difference between relapsing proportions.
CONCLUSION:
The addition of diclofenac sodium to imipramine in treating patients with primary nocturnal enuresis might have caused a highly significant higher response rate and a fairly significant lower relapse rate after cessation of treatment.