COMPARATIVE EFFICACY OF OXYBUTYNIN AND IMIPRAMINE FOR THE TREATMENT OF PRIMARY NOCTURNAL ENURESIS IN A TERTIARY CARE HOSPITAL OF ABBOTTABAD
SUBMISSION DATE: 20/11/25 | ACCEPTANCE DATE: 10/12/25 | PUBLICATION DATE: 25/12/25
Nadia Amin1, Amjad Iqbal1, Aziz Ullah2, Ali Bashir2, Murad Ali3
1 Combined Military Hospital, Abbottabad
2 Ayub Teaching Hospital, Abbottabad
3 Khyber Teaching Hospital, Peshawar
CORRESPONDING AUTHOR: DR AMJAD IQBAL, PROFESSOR OF PAEDIATRICS, COMBINED MILITARY HOSPITAL, ABBOTTABAD
ABSTRACT:
BACKGROUND: Primary nocturnal enuresis (PNE), a common pediatric disease, requires drug therapy when behavioral treatments are ineffective. Although imipramine, a tricyclic antidepressant, and oxybutynin, an anticholinergic drug, are both well-established medications, there is a dearth of direct comparative evidence about their safety profiles, relapse rates, and effectiveness.
AIM AND OBJECTIVES: The aim of this study is to evaluate oxybutynin and imipramine’s treatment effectiveness, relapse rate, and side effects in children with primary nocturnal enuresis.
METHODS: For a predetermined treatment period, 78 children with PNE diagnoses were recruited and randomized to receive either imipramine (n = 39) or oxybutynin (n = 39) at the Department of Pediatric of Combined Military Hospital, Abbottabad from August to November 2025. SPSS 26 was used to examine data on side effects, relapse, treatment response, and demographic characteristics. Mann-Whitney U test, chi square test and t-test was used to compare the variables between the two groups.
RESULTS: The median age was similar between groups. The response rate for oxybutynin was significantly higher (76.9%) than that of imipramine (41.0%) (p = 0.001). 10.3% of the oxybutynin group experienced relapse, compared to 28.2% of the imipramine group (p = 0.044). Rates of anxiety, sleeplessness, and nausea were similar (p > 0.05 for all), but dry mouth was more common with oxybutynin (p = 0.008).
CONCLUSION: With a manageable side effect profile, oxybutynin outperformed imipramine in terms of efficacy and relapse rates. For primary nocturnal enuresis, it can be the recommended first-line pharmacologic treatment. In order to confirm these results and evaluate long-term effects, larger multicenter trials are necessary.
KEYWORDS: Primary nocturnal enuresis, Oxybutynin, Imipramine, Comparative study ,Pediatric urology, Therapeutic efficacy , Anticholinergic agents , Tricyclic antidepressants.