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Desmopressin add-on therapy for refractory nocturia in men receiving α-blockers for lower urinary tract symptoms.
J Urol. 2013 Jul; 190(1):180-6.JU

Abstract

PURPOSE

Alpha-blockers improve lower urinary tract symptoms associated with benign prostatic obstruction. Nocturia, a storage symptom, is a common complaint in men. However, it does not fully respond to α-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 α-blocker for lower urinary tract symptoms.

MATERIALS AND METHODS

Eligible patients were men 50 years old or older with lower urinary tract symptoms and persistent nocturia despite α-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, International Prostate Symptom Score total and subscores, uroflowmetry and post-void residual urine volume were assessed.

RESULTS

A total of 216 patients were enrolled in the study. Of these patients there were 158 (76%) 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 International Prostate Symptom Score total and subscore significantly decreased by 4 weeks and were maintained at 24 weeks. In patients younger than 65 years, International Prostate Symptom Score voiding subscores were significantly improved at 24 weeks compared to those age 65 years or older.

CONCLUSIONS

Desmopressin add-on therapy for refractory nocturia in men previously treated with an α-blocker for lower urinary tract symptoms improved voiding symptoms as well as nocturia, storage symptoms.

Authors+Show Affiliations

Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23357213

Citation

Bae, Woong Jin, et al. "Desmopressin Add-on Therapy for Refractory Nocturia in Men Receiving Α-blockers for Lower Urinary Tract Symptoms." The Journal of Urology, vol. 190, no. 1, 2013, pp. 180-6.
Bae WJ, Bae JH, Kim SW, et al. Desmopressin add-on therapy for refractory nocturia in men receiving α-blockers for lower urinary tract symptoms. J Urol. 2013;190(1):180-6.
Bae, W. J., Bae, J. H., Kim, S. W., Chung, B. H., Kim, J. H., Kim, C. S., Lee, H. M., Lee, K. S., Yoo, T. K., Kim, S. I., Byun, S. S., & Lee, J. Y. (2013). Desmopressin add-on therapy for refractory nocturia in men receiving α-blockers for lower urinary tract symptoms. The Journal of Urology, 190(1), 180-6. https://doi.org/10.1016/j.juro.2013.01.057
Bae WJ, et al. Desmopressin Add-on Therapy for Refractory Nocturia in Men Receiving Α-blockers for Lower Urinary Tract Symptoms. J Urol. 2013;190(1):180-6. PubMed PMID: 23357213.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Desmopressin add-on therapy for refractory nocturia in men receiving α-blockers for lower urinary tract symptoms. AU - Bae,Woong Jin, AU - Bae,Jang Ho, AU - Kim,Sae Woong, AU - Chung,Byung Ha, AU - Kim,Jang Hwan, AU - Kim,Choung Soo, AU - Lee,Hyun Moo, AU - Lee,Kyung Seop, AU - Yoo,Tag Keun, AU - Kim,Sun Il, AU - Byun,Seok Soo, AU - Lee,Ji Youl, Y1 - 2013/01/25/ PY - 2013/01/17/accepted PY - 2013/1/30/entrez PY - 2013/1/30/pubmed PY - 2013/8/24/medline SP - 180 EP - 6 JF - The Journal of urology JO - J. Urol. VL - 190 IS - 1 N2 - PURPOSE: Alpha-blockers improve lower urinary tract symptoms associated with benign prostatic obstruction. Nocturia, a storage symptom, is a common complaint in men. However, it does not fully respond to α-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 α-blocker for lower urinary tract symptoms. MATERIALS AND METHODS: Eligible patients were men 50 years old or older with lower urinary tract symptoms and persistent nocturia despite α-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, International Prostate Symptom Score total and subscores, uroflowmetry and post-void residual urine volume were assessed. RESULTS: A total of 216 patients were enrolled in the study. Of these patients there were 158 (76%) 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 International Prostate Symptom Score total and subscore significantly decreased by 4 weeks and were maintained at 24 weeks. In patients younger than 65 years, International Prostate Symptom Score voiding subscores were significantly improved at 24 weeks compared to those age 65 years or older. CONCLUSIONS: Desmopressin add-on therapy for refractory nocturia in men previously treated with an α-blocker for lower urinary tract symptoms improved voiding symptoms as well as nocturia, storage symptoms. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/23357213/Desmopressin_add_on_therapy_for_refractory_nocturia_in_men_receiving_α_blockers_for_lower_urinary_tract_symptoms_ L2 - https://www.jurology.com/doi/full/10.1016/j.juro.2013.01.057?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -