PURPOSE: Alpha-blockers improve lower urinary tract symptoms (LUTS) associated with benign prostatic obstruction (BPO).
Nocturia-a storage symptom-is a common complaint in men, however, it does not fully respond to alpha-blocker therapy, likely due to its multifactorial pathophysiology. We evaluated the efficacy and safety of desmopressin as add-on therapy for refractory nocturia in men previously treated with an alpha-blocker for LUTS.
MATERIALS AND METHODS: Eligible patients were men 50 years of age or older with LUTS and persistent nocturia despite alpha-blocker treatment for a minimum of 4 weeks. The optimum dose of oral desmopressin was determined during a 4-week dose-titration period, and this dose was maintained for 24 weeks. Flow volume charts, total IPSS, IPSS subscores, uroflowmetry and post-void residual urine volume were assessed.
RESULTS AND CONCLUSIONS: A total of 216 patients were enrolled in the study. Of these patients, there were 158(76%) patients with nocturnal polyuria, 15(7.2%) with decreased nocturnal bladder capacity, and 35(16.8%) with nocturia due to both causes. The number of nocturnal voids significantly decreased from a baseline mean of 7.0 to 5.7 episodes for 3 days at the 24 week visit. The average IPSS total and IPSS subscore significantly decreased by 4 weeks and were maintained at 24 weeks. In patients aged less than 65 years, IPSS voiding subscores were significantly improved at 24 weeks compared to those 65 years or over. Desmopressin add-on therapy for refractory nocturia in men previously treated with an alpha-blocker for LUTS improved voiding symptoms as well as nocturia, storage symptoms.
Written by:
Bae WJ, Bae JH, Kim SW, Chung BH, Kim JH, Kim CS, Lee HM, Lee KS, Yoo TK, Kim SI, Byun SS, Lee JY. Are you the author?
Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
Reference: J Urol. 2013 Jan 25. pii: S0022-5347(13)00093-1.
doi: 10.1016/j.juro.2013.01.057
PubMed Abstract
PMID: 23357213
