유뇨증에서 벨알람 행동요법과 oxybutynin 치료의 비교

Abstract

Objects : The authors evaluated the clinical efficacy of Bell-alarm treatment compared with oxybutynin administration in nocturnal enuretic patients with associated symptoms such as unnary frequency and urgency, daytime enuresis, and encopresis. Methods : We assessed the weekly frequencies of bed-wetting of 14 subjects treated with oxybutynin administration during 6week(short-term) and 6-month(long-term) treatments, and then 6-month follow-up period. Therapeutic 'response' was defined as a persistent dry period of at least 2 weeks after bed-wetting frequency being decreased to less than twice a week. Results : The results were summarized as follows : 1) Between Bell-alarm and Oxybutynin groups, there are no significant demographic differences such as age, sex ratio and family history of enuresis. 2) Associated urinary symptoms such as urgency, frequency, daytime enuresis were noted in 12 subjects(86%) of oxybutynin group compared to 11 subjects(79%) of Bell-alarm group, but group differences were not significant. 3) In comparative short-term trials of oxybutynin versus alarm, oxybutynin was effective in 71.4%(10 of 14) of enuretics, and alarm was effective in 9.1%(1 of 7 subjects). But oxybutynin was effective in 71.4%, and alarm was effective in 90.1%(10 of 11) in long-term trials. Two subjects(20%) treated with bell-alarm relapsed, otherwise 5 subjects(50%) relapsed in oxybutynin group during 6 month follow-up period. significant decrease of bed-wetting frequency in oxybutynin group showed earlier than in bell-alarm group. Conclusion This results suggest that the short term therapeutic effect of oxybutynin may be superior to Bell-alarm in nocturnal enuresis. But the long-term efficacy and the relapse rate of Bell-alarm method seem to be as effective as oxybutynin administration in treating nocturnal enuresis.