The pharmacological treatment of nocturia

Andersson, Karl‐Erik

doi:10.1046/j.1464-410x.90.s3.7.x

Cited by 15 publications

(10 citation statements)

References 5 publications

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“…LUTS are one of the major causes of nocturia in older men , while the pathophysiology of nocturia is considered multifactorial. NP as a result of age‐associated changes in the circadian rhythm of urine excretion is the main mechanisms of nocturia . As a consequence of different definitions, the prevalence of NP in nocturia was reported to be 45–100% .…”

Section: Discussionmentioning

confidence: 99%

Comparison of nocturia response to desmopressin treatment in elderly men with and without nocturnal polyuria in real-life practice

et al. 2016

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Objectives: To evaluate the safety and efficacy of low-dose desmopressin in elderly men with and without nocturnal polyuria (NP) in real-life practice. Methods: Patients with lower urinary tract symptoms (LUTS)/ benign prostate hyperplasia (BPH) who were≧ 65 years old with refractory nocturia were enrolled in this study. We retrospectively analysed elderly men treated with adding desmopressin to current medications for nocturia according to category of the baseline nocturnal urine volume. The 48-h frequency volume chart (FVC), International Prostate Symptom Score (IPSS) and quality of life (QoL) were initially assessed and reevaluated 12 weeks later. Serum sodium level was checked 1 week, 4 weeks, and 12 weeks after initiation of desmopressin therapy or suspected hyponatremia event. The mean change in numbers of nocturnal voids was evaluated for efficacy of treatment. Results: A total of 136 patients were included with 55 in non-NP group and 81 in NP group. Hypertension was more common in NP group in regard of comorbidities. During treatment period, there were significant reductions of nocturnal voids from 4.22 AE 1.38 to 2.31 AE 0.98 (p < 0.001) in non-NP group and from 4.52 AE 1.23 to 2.07 AE 0.89 (p < 0.001) in NP group. The reduction in nocturnal voids was more significant in NP group (2.44 AE 1.15 vs. 1.91 AE 1.48, p = 0.003). The mean decrease in serum sodium levels were 3.89 AE 1.22 mmol/l (p < 0.001) in non-NP group and 4.69 AE 3.5 mmol/l (p < 0.001) in NP group at the extreme value. Conclusions: Long-term treatment with low-dose desmopressin is safe and effective for nocturia with or without NP in elderly patients with LUTS/BPH during real-life practice. Patients should be well informed about the disease and are closely followed. What's known• Nocturia is a common reason for interrupted sleep in elderly adults. As patients continue to grow, the complaint of nocturia will become more common and our patients will continue to demand effective and safe therapies to get them through the night.• Nocturnal polyuria (NP) is a subclassification of nocturia characterised by nocturnal urine volume that is over 33% of the 24-h voided volume.• Desmopressin has level 1 evidence and grade A recommendation for the treatment of nocturia because of NP. Randomised, placebo-controlled studies in adults with nocturia because of NP showed that desmopressin can significantly reduce the number of nocturnal voids, decreases the ratio of night/24-h urine volume. What's new• This study revealed that noctutria continued to bother elderly men with lower urinary tract symptoms suggestive of benign prostate hyperplasia despite of stereotyped medical therapy. Adding on low-dose oral desmopressin in real-life practice was shown to be safe and effective for patients over 65 years with nocturia. It also demonstrated desmopressin reduced nocturnal void, IPSS total score and quality of life index not only in NP patients but also in non-NP group in elderly men with comorbidities in reallife practice.

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Section: Discussionmentioning

confidence: 99%

Comparison of nocturia response to desmopressin treatment in elderly men with and without nocturnal polyuria in real-life practice

et al. 2016

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“…Nocturia was measured by using the IT-NQoL, which evaluates the impact of nocturia on QoL using 13 items (12 directly related to nocturia and one to general QoL) [4]. The items related to nocturia (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12) have a response scale with five choices, ranging from 0 (absence of symptoms) to 4 (symptoms always present), while the item related to QoL (13) has a response scale with 11 choices, ranging from 0 (absence of nocturia impact on subject QoL) to 10 (severe nocturia impact on subject QoL). The items related to nocturia were grouped into two subscales; one explores the relationship between the impact of nocturia on quality of sleep and energy the day after, and the other the relationship between having to get up at night to urinate and related worries.…”

Section: Methodsmentioning

confidence: 99%

“…Nocturia can be caused by many factors and is often related to ageing [3]. The incidence of nocturia increases with age and authors reported a frequency of 16% in men aged 40-49 years, to 60% in men aged 70-79 years [4,5].…”

Section: Introductionmentioning

confidence: 99%

Impact of surgical treatment on nocturia in men with benign prostatic obstruction

Cai¹,

Gardener

Abraham

et al. 2006

BJU International

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Several important topics are presented in this section, including the impact of surgical treatment on nocturia in men with BPH, pelvic floor exercises for stress urinary incontinence, chronic prostatitis in puberty, introital ultrasonography, and a systematic review published work on a stent for managing BPH. OBJECTIVES To validate the International Consultation on Incontinence Nocturia Quality‐of‐life (NQoL) questionnaire in Italian (IT‐NQoL) and use it to evaluate the impact of surgical treatment on nocturia in men with lower urinary tract symptoms related to benign prostatic obstruction (LUTS/BPO). PATIENTS AND METHODS All men attending one urological unit between November 2004 and April 2005 were enrolled in the study. They were assessed in two groups; those with and with no LUTS/BPO. An Italian translation of the NQoL was devised, and patients then completed this and validated Italian versions of the International Prostate System Score (IPSS), the Pittsburg Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Clinical, laboratory and instrumental data from each patient were recorded. The patients with LUTS/BPO then had surgical treatment, and 6 months later those with LUTS/BPO were asked to complete all the questionnaires again to evaluate the test sensitivity to change. RESULTS Of the 109 patients enrolled in the study, 61 were affected by LUTS/BPO and 48 were not. Cronbach’s α for the IT‐NQoL was 0.943 (95% confidence interval, CI, 0.922–0.959; P < 0.001) and the intra‐class correlation coefficient was 0.999 (95% CI 0.998–0.999; P < 0.001) for the total IT‐NQoL score. The correlation between the test and the re‐test was statistically significant (P < 0.001; r = 0.999) for all items. The mean (sd) IT‐NQoL score showed an improvement in QoL from before, at 23.4 (10.1), to after treatment, at 3.09 (2.48) (P < 0.001). In the LUTS/BPO group, the IT‐NQoL correlated with the number of times when waking to urinate (Pearson’s coefficient 0.80, P < 0.001). There was also a correlation for ESS (0.796) and for the seven PSQI subscales (0.614, both P < 0.001). The decrease in sleep quality, duration and efficiency resulted in an increase in daytime sleepiness (r = 0.639, 0.642). At the 6‐month follow‐up, all questionnaire results were statistically different from those before treatment. CONCLUSIONS The IT‐NQoL is the first validated translation of the primary instrument into another language. This version is easy to use and has the same characteristic validity as the English version. Using the IT‐NQoL showed that surgical treatment determines a decrease in the nocturia rate and an increase in QoL. There was also a significant increase in QoL after treatment as assessed by all the other questionnaires.

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“…The effects of several drugs and drug classes on nocturia have also been extensively investigated. However, desmopressin has been associated with an increased risk of hyponatraemia and water retention, and so care must be taken when using desmopressin in the treatment of older patients [16]. Also, anticholinergics may be relatively contraindicated in men with BOO.…”

Section: Discussionmentioning

confidence: 99%

α‐blocker monotherapy in the treatment of nocturia in men with lower urinary tract symptoms: a prospective study of response prediction

Paick

Shin

et al. 2006

BJU International

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The pharmacological treatment of nocturia

Cited by 15 publications

References 5 publications

Comparison of nocturia response to desmopressin treatment in elderly men with and without nocturnal polyuria in real-life practice

Comparison of nocturia response to desmopressin treatment in elderly men with and without nocturnal polyuria in real-life practice

Impact of surgical treatment on nocturia in men with benign prostatic obstruction

α‐blocker monotherapy in the treatment of nocturia in men with lower urinary tract symptoms: a prospective study of response prediction

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