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Desmopressin Add-On Therapy for Refractory Nocturia in Men Receiving α-Blockers for Lower Urinary Tract Symptoms

Authors
 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 
Citation
 JOURNAL OF UROLOGY, Vol.190(1) : 180-186, 2013 
Journal Title
 JOURNAL OF UROLOGY 
ISSN
 0022-5347 
Issue Date
2013
MeSH
Adrenergic alpha-Antagonists/therapeutic use* ; Aged ; Analysis of Variance ; Cohort Studies ; Confidence Intervals ; Deamino Arginine Vasopressin/therapeutic use* ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Drug Therapy, Combination ; Follow-Up Studies ; Humans ; Lower Urinary Tract Symptoms/drug therapy* ; Lower Urinary Tract Symptoms/etiology ; Lower Urinary Tract Symptoms/physiopathology ; Male ; Middle Aged ; Nocturia/drug therapy* ; Nocturia/etiology ; Nocturia/physiopathology ; Prospective Studies ; Prostatic Hyperplasia/complications* ; Prostatic Hyperplasia/diagnosis ; Quality of Life ; Risk Assessment ; Severity of Illness Index ; Treatment Outcome ; Urodynamics
Keywords
prostatic hyperplasia ; deamino arginine vasopressin ; nocturia
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.
Full Text
http://www.sciencedirect.com/science/article/pii/S0022534713000931
DOI
10.1016/j.juro.2013.01.057
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jang Hwan(김장환) ORCID logo https://orcid.org/0000-0002-9056-7072
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/88248
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