Desmopressin add-on therapy for refractory nocturia in men receiving α-blockers for lower urinary tract symptoms

Woong Jin Bae, Jang Ho Bae, Sae Woong Kim, Byung Ha Chung, Jang Hwan Kim, Choung Soo Kim, Hyun Moo Lee, Kyung Seop Lee, Tag Keun Yoo, Sun Il Kim, Seok Soo Byun, Ji Youl Lee

Research output: Contribution to journalArticle

21 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)180-186
Number of pages7
JournalJournal of Urology
Volume190
Issue number1
DOIs
Publication statusPublished - 2013 Jul 1

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Nocturia
Deamino Arginine Vasopressin
Lower Urinary Tract Symptoms
Prostate
Therapeutics
Polyuria
Residual Volume
Urinary Bladder
Urine
Safety

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Bae, Woong Jin ; Bae, Jang Ho ; Kim, Sae Woong ; Chung, Byung Ha ; Kim, Jang Hwan ; Kim, Choung Soo ; Lee, Hyun Moo ; Lee, Kyung Seop ; Yoo, Tag Keun ; Kim, Sun Il ; Byun, Seok Soo ; Lee, Ji Youl. / Desmopressin add-on therapy for refractory nocturia in men receiving α-blockers for lower urinary tract symptoms. In: Journal of Urology. 2013 ; Vol. 190, No. 1. pp. 180-186.
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title = "Desmopressin add-on therapy for refractory nocturia in men receiving α-blockers for lower urinary tract symptoms",
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.",
author = "Bae, {Woong Jin} and Bae, {Jang Ho} and Kim, {Sae Woong} and Chung, {Byung Ha} and Kim, {Jang Hwan} and Kim, {Choung Soo} and Lee, {Hyun Moo} and Lee, {Kyung Seop} and Yoo, {Tag Keun} and Kim, {Sun Il} and Byun, {Seok Soo} and Lee, {Ji Youl}",
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Bae, WJ, Bae, JH, Kim, SW, Chung, BH, Kim, JH, Kim, CS, Lee, HM, Lee, KS, Yoo, TK, Kim, SI, Byun, SS & Lee, JY 2013, 'Desmopressin add-on therapy for refractory nocturia in men receiving α-blockers for lower urinary tract symptoms', Journal of Urology, vol. 190, no. 1, pp. 180-186. https://doi.org/10.1016/j.juro.2013.01.057

Desmopressin add-on therapy for refractory nocturia in men receiving α-blockers for lower urinary tract symptoms. / Bae, Woong Jin; Bae, Jang Ho; Kim, Sae Woong; Chung, Byung Ha; Kim, Jang Hwan; Kim, Choung Soo; Lee, Hyun Moo; Lee, Kyung Seop; Yoo, Tag Keun; Kim, Sun Il; Byun, Seok Soo; Lee, Ji Youl.

In: Journal of Urology, Vol. 190, No. 1, 01.07.2013, p. 180-186.

Research output: Contribution to journalArticle

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

PY - 2013/7/1

Y1 - 2013/7/1

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.

AB - 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.

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