Drug combo may help curb bedwetting

By David Douglas

NEW YORK (Reuters Health) - In children who continue to wet the bed despite standard treatment with desmopressin, adding the bladder-control drug tolterodine (Detrol) to therapy leads to a significant decrease in the risk of bedwetting, Missouri-based researchers have found.

Desmopressin, lead researcher Dr. Paul F. Austin told Reuters Health, is the most frequently prescribed medication for bedwetting "and we, along with others, have found that functional bladder capacity is a reliable predictor of response to desmopressin. Children with larger bladders are more likely to exhibit a successful response."

Therefore, his team sought to see if adding another medicine that increases bladder capacity, like tolterodine, would thereby increase the response to desmopressin.

Accordingly, Austin, of Washington University School of Medicine, St. Louis, and colleagues randomly assigned 41 children who had not responded adequately to desmopressin to continue with the drug in combination with tolterodine or placebo.

After 1 month of treatment and exclusion of 7 "noncompliant" patients, the team found a significant 66 percent reduction in the risk of bedwetting in the combination therapy group.

The combination group also had a higher rate of full or partial response (44 percent) than the placebo group (31 percent). Moreover, only 16.5 percent of patients in the study group had a complete lack of response, compared to 44 percent in the placebo group.

"We showed .... that there was a significant reduction in the mean number of wet nights in the combination therapy group as compared to placebo," Austin noted.

SOURCE: Pediatrics November 2008.