Analysis of curative effects of Tolterodine combined with Desmopressin acetate in the treatment of overactive bladder in children with diurnal urinary incontinence / 中华实用儿科临床杂志

ABSTRACT

Objective:To evaluate the efficacy and safety of Tolterodine combined with Desmopressin acetate in the treatment of overactive bladder in children with diurnal urinary incontinence.Methods:Clinical data of 55 overactive bladder children with diurnal urinary incontinence in Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2016 to December 2018 were collected.The urodynamic examination on all patients excluded factors such as neurogenic bladder and spinal cord trauma from the causes of urinary incontinence.Twenty-eight patients underwent Tolterodine plus Desmopressin acetate, and the remaining 27 patients were treated with Tolterodine alone.The course of medication was determined according to whether the clinical symptoms disappeared or not.According to the ratings of overactive bladder, the treatment effects of all children were evaluated and divided into complete improvement, obvious improvement, and little or no improvement.The effectivity was defined as complete and obvious improvement, while the ineffectiveness was defined as little or no improvement.Meanwhile, adverse effects like dry mouth, blushing and constipation were observed.Results:In the Tolterodine+ Desmopressin acetate group, 15 cases were improved completely (53.6%, 15/28 cases), 11 cases were obviously improved (39.3%, 11/28 cases), 2 cases were slightly or not improved (7.1%, 2/28 cases). The effective rate was 92.9% (26/28 cases). In the Tolterodine group, 9 cases were improved completely (33.3%, 9/27 cases), 11 cases were obviously improved (40.7%, 11/27 cases), and 7 cases (25.9%, 7/27 cases) were not or slightly improved.The effective rate was 74.1% (20/27 cases). The difference of the effective rate between the 2 groups was statistically significant ( χ2=9.61, P<0.05). Six cases (21.4%, 6/28 cases) in the Tolterodine+ Desmopressin acetate group presented adverse reactions, and that number was 5 (18.5%, 5/27 cases) in the Tolterodine group.There was no significant difference in the proportion of adverse reaction events between the 2 groups. Conclusions:Tolterodine combined with Desmopressin acetate can significantly improve symptoms and reduce urinary incontinence events in children with overactive bladder and diurnal urinary incontinence.The combined use of Tolterodine and Desmopressin acetate is safe and well tolerated, with better efficacy than Tolterodine alone.Therefore, it is recommended as a new treatment for overactive bladder in children with diurnal urinary incontinence.