Prophylactic Treatment of Adult Nocturia with Bumetanide

Abstract

The efficacy of 1 mg bumetanide on nocturia was compared with placebo in a randomised double-blind cross-over study in general practice. Twenty-eight patients, 13 females and 15 males, completed two treatment periods of 2 weeks' duration. During the placebo period the weekly number of nocturia episodes was 13.8 and during bumetanide treatment the number was reduced by 3.8. Ten males had a history of prostatic hypertrophy and in these patients treatment with bumetanide was not beneficial. In the remaining 18 patients the weekly number of nocturia episodes was reduced by 4 during bumetanide treatment compared with the placebo period. Of these patients, 3 preferred treatment with placebo, 11 preferred bumetanide and 4 gave no preference. These results suggest that bumetanide offers an alternative in the treatment of adult nocturia not connected with enlargement of the prostate.

Nocturia: Current Levels of Evidence and Recommendations From the International Consultation on Male Lower Urinary Tract Symptoms

“…27 A decrease of 4 nightly voids per week was seen in the treatment group only after excluding the 10 patients with benign prostatic hyperplasia (LOE 3).…”

Is our current understanding and management of nocturia allowing improved care? International Consultation on Incontinence‐Research Society 2018

“…However, the association between NP and HT has only been confirmed in 2017 by Yokoyama et al Some older and smaller studies support this association too: in 1996, Matthiesen et al, showed that mean arterial pressure is higher in patients with NP than in controls and higher night/day ratios of urinary sodium excretion are associated with raised blood pressure. Interestingly, two randomized controlled trials from 1988 showed that nocturia in elderly patients with NP is alleviated by giving loop diuretics during the day …”

Managing nocturia: Fig 1

“…Depending on the diagnosis and underlying cause(s), treatment options for nocturnal polyuria may include restriction of fluids in the evening, time release diuretics,19 afternoon naps, elevation of the legs, compression stockings, and treatment with antidiuretic hormone. Accumulation of fluid in the lower extremities in some patients may eliminate simple fluid restriction as an effective alternative.…”