Abstract
In nocturnal enuresis motivational therapy, alarm therapy and drug therapy such as anticholinergics, imipramine and sertraline are the mainstay of treatment. In this study, we used motivational therapy, oxybutynin and propranolol in children with primary nocturnal enuresis to determine if propranolol is effective in the treatment of primary nocturnal enuresis. Fifty two children with primary nocturnal enuresis were included in the study. Firstly, motivational motivational therapy was given for 1 month in all patients. Patients who failed by motivational therapy were randomly given oxybutynin or propranolol. The patients were re-evaluated after 1 month of drug therapy. There was not a significant difference between oxybutynin and propranolol groups for initial frequency of nocturnal enuresis (P >0.05). Of 52 patients, 28 (53.8%) patients were improved by motivational therapy. There were 14 patients in oxybutynin group. One patient was excluded from the study because facial flushing and mouth drying developed in the first week of oxybutynin therapy. In oxybutynin group, 12 (92.3%) of 13 patients were improved. There were 10 patients in propranolol group. In propranolol group, while nine (90%) patients were not improved, one patient had significant remission (90%) (P <0.001). No significant adverse reaction was noted during propranolol therapy. A significant difference was found between the groups for remission of nocturnal enuresis (P <0.001). Our findings showed that motivational therapy is the first line treatment in primary nocturnal enuresis and oxybutynin but not propranolol is effective in patients who failed with motivational therapy.

Key words: Primary enuresis nocturna; Child; Motivational therapy; Oxybutynin; Propranolol