Hann Chorng Kuo1. 1. Department of Urology, Buddhist Tzu Chi General Hospital, Republic of, Hualien, Taiwan, China.
Abstract
OBJECTIVES: To evaluate the efficacy of desmopressin treatment in patients 65 years old and older with nocturia and to determine whether baseline urodynamic characteristics influenced the outcome of treatment. METHODS: Patients with nocturia three or more times a night and nocturnal polyuria refractory to medication were treated with oral desmopressin 0.1 mg at bedtime for 4 weeks. Data from urodynamic studies and a voiding diary, nocturnal urine volume, urine specific gravity, serum sodium and potassium level, and quality of life index were measured at baseline, 4 weeks, and 4 weeks after discontinuation of treatment. RESULTS: A total of 30 patients (25 men and 5 women) were enrolled in the study. The mean age was 75.4 +/- 6.6 years. Five patients (16.7%) reported side effects, including hyponatremia in one. Twenty patients (66.7%) reported a good response with both reduced nocturnal frequency (5.2 +/- 1.16 times versus 2.24 +/- 1.12 times a night, P = 0.000) and urine volume (955.6 +/- 255.9 mL versus 522.8 +/- 210.5 mL, P <0.0001). Two patients (6.7%) had improved nocturnal frequency, and 3 patients (10%) reported no effect at all. After discontinuing the medication for 4 weeks, 13 patients (52%) had improved symptoms compared with baseline and 6 (24%) remained at their post-treatment frequency of nocturia. Urodynamic studies revealed that 15 patients had detrusor instability and 17 had a cystometric capacity of 250 mL or less. No significant difference was found in the success rate relative to the urodynamic results. CONCLUSIONS: Desmopressin is safe and effective in the treatment of severe nocturia in patients 65 years old and older.
OBJECTIVES: To evaluate the efficacy of desmopressin treatment in patients 65 years old and older with nocturia and to determine whether baseline urodynamic characteristics influenced the outcome of treatment. METHODS:Patients with nocturia three or more times a night and nocturnal polyuria refractory to medication were treated with oral desmopressin 0.1 mg at bedtime for 4 weeks. Data from urodynamic studies and a voiding diary, nocturnal urine volume, urine specific gravity, serum sodium and potassium level, and quality of life index were measured at baseline, 4 weeks, and 4 weeks after discontinuation of treatment. RESULTS: A total of 30 patients (25 men and 5 women) were enrolled in the study. The mean age was 75.4 +/- 6.6 years. Five patients (16.7%) reported side effects, including hyponatremia in one. Twenty patients (66.7%) reported a good response with both reduced nocturnal frequency (5.2 +/- 1.16 times versus 2.24 +/- 1.12 times a night, P = 0.000) and urine volume (955.6 +/- 255.9 mL versus 522.8 +/- 210.5 mL, P <0.0001). Two patients (6.7%) had improved nocturnal frequency, and 3 patients (10%) reported no effect at all. After discontinuing the medication for 4 weeks, 13 patients (52%) had improved symptoms compared with baseline and 6 (24%) remained at their post-treatment frequency of nocturia. Urodynamic studies revealed that 15 patients had detrusor instability and 17 had a cystometric capacity of 250 mL or less. No significant difference was found in the success rate relative to the urodynamic results. CONCLUSIONS: Desmopressin is safe and effective in the treatment of severe nocturia in patients 65 years old and older.
Authors: Lee Hooper; Asmaa Abdelhamid; Natalie J Attreed; Wayne W Campbell; Adam M Channell; Philippe Chassagne; Kennith R Culp; Stephen J Fletcher; Matthew B Fortes; Nigel Fuller; Phyllis M Gaspar; Daniel J Gilbert; Adam C Heathcote; Mohannad W Kafri; Fumiko Kajii; Gregor Lindner; Gary W Mack; Janet C Mentes; Paolo Merlani; Rowan A Needham; Marcel G M Olde Rikkert; Andreas Perren; James Powers; Sheila C Ranson; Patrick Ritz; Anne M Rowat; Fredrik Sjöstrand; Alexandra C Smith; Jodi J D Stookey; Nancy A Stotts; David R Thomas; Angela Vivanti; Bonnie J Wakefield; Nana Waldréus; Neil P Walsh; Sean Ward; John F Potter; Paul Hunter Journal: Cochrane Database Syst Rev Date: 2015-04-30