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At least 19 recordsLinked to original sources
PubMed1999

Evaluation of the etiology of nocturia in men: the nocturia and nocturnal bladder capacity indices.

To determine and quantify the cause of nocturia in men, we describe and evaluate the relative contribution of two complementary indices of nocturia: the nocturia index (Ni), a measure of nocturnal urine overproduction, and the nocturnal bladder capacity index (NBCi), reflective of nocturnal bladder capacity. The records of 100 consecutive men with lower urinary tract symptoms (LUTS), having undergone video-urodynamic studies (VUDS), were prospectively studied. Evaluation included American Urological Association symptom score (AUASS), micturition diary (day, night, and 24-hr voided volume), and VUDS. Voiding diary analysis was carried out as previously described by us, determining the Ni, NBCi, and nocturnal polyuria index (NPi) (nocturnal urine volume/24-hr urine volume). In the case of AUASS question #7 (degree of nocturia), the odds of having a severe AUA question #7 response was found to be 4.09 times higher for patients with NBCi > 2.0 compared with patients whose NBCi was </= 2.0 using logistic regression analysis. In comparing patients with severe nocturia and low NBCi with those having mild nocturia and low NBCi, Ni performed in a fashion superior to NPi in identifying relative nocturnal urine overproduction as the suspected explanation for their nocturia (Ni = 3.42 vs. 1.42, P = 0.0002 cf. Npi = 0.44 vs. 0.27, P = 0.018, Mann-Whitney test, respectively). We suggest a discriminating threshold of NBCi > 2 as highly significant in defining diminished NBC as a factor in the etiology of nocturia. In addition, we propose Ni of 1.5 as a threshold greater than which nocturia may be attributed to nocturnal urine overproduction in excess of maximum bladder capacity. Together, these indices describe in quantitative fashion the relative contributions of nocturnal urine overproduction and diminished NBC in identifying the etiology of nocturia in male patients. Neurourol. Urodynam. 18:559-565, 1999.

Aged↗
PubMed2004

Nocturia and complementary indices: determination and quantification of the cause of nocturia by frequency-volume charts in women with lower urinary tract symptoms.

We evaluated differences between women with lower urinary tract symptoms (LUTS) with and without nocturia in terms of voiding habits, urine production and voided volumes in order to determine and quantify the cause of nocturia by using frequency-volume (FV) charts. At the initial visit, all patients underwent a detailed clinical evaluation including an International Prostate Symptom Score assessment, received a thorough explanation from the study coordinators, and were requested to complete a 3-day FV chart. Of the 123 women enrolled, 106 (86.2%) 20-83 years old (median age 55.0) completed the study. Nocturnal urine volume was higher in nocturics than in non-nocturics, but this was not statistically significant. Total daytime voided volume was lower in nocturics than in non-nocturics ( P=0.030) but with no detectable difference in total voided volume. To identify possible risk factors, we examined age and night time parameters including the nocturnal bladder capacity index (NBCI), nocturnal polyuria index (NPI) and nocturia index (NI) by univariate logistic analysis. When nocturia was defined as voiding at least twice per night, age and NI were found to be associated with it by univariate analysis. These two variables were further analyzed using a multivariate logistic model to determine their association with nocturia. In the multivariate analysis, a positive association was observed between age and nocturia. Patients 50 years or older had a 3.9-fold higher risk [odds ratio (OR) 3.86; 95% confidence interval (CI) 1.60-9.31; P=0.003] of voiding at least twice per night than those younger than 50 years. In the same model, patients with NI greater than 1.5 had a 4.5-fold higher risk of voiding at least twice per night (OR 4.59; 95% CI 1.80-11.17; P=0.001). FV charts are valuable for determining the cause of nocturia in women with LUTS. Our findings suggest that age and the NI may be important variables in the evaluation of nocturia in women with LUTS.

Adult↗
PubMed2003

Changes in nocturia from medical treatment of benign prostatic hyperplasia: secondary analysis of the Department of Veterans Affairs Cooperative Study Trial.

PURPOSE: We evaluate the efficacy of medical therapy on nocturia in men with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: We performed a secondary analysis of data from the VA Cooperative Study Program Trial in which 1,229 men with BPH 45 to 80 years old were randomly assigned to receive terazosin, finasteride, combination or placebo. RESULTS: The 1,078 men who completed 12 months of the trial are included in this study. Of those men 1,040 (96.5%) had at least 1 episode of nocturia at baseline and 38 (3.5%) had less than 1 episode (baseline nocturia is an average of 2 measures). Of those 1,040 men 788 (75.8%) had 2 or more nocturia episodes. Overall, nocturia decreased from a baseline mean of 2.5 to 1.8, 2.1, 2.0 and 2.1 episodes in the terazosin, finasteride, combination and placebo groups, respectively. Of men with 2 or more episodes of nocturia 50% reduction in nocturia was seen in 39%, 25%, 32% and 22% in the terazosin, finasteride, combination and placebo groups, respectively. Changes in nocturia were correlated with changes in reported bother from nocturia (Pearson correlation 0.48), BPH impact index (0.32) and overall satisfaction with urinary symptoms (0.33). CONCLUSIONS: Terazosin and combination therapy reduced nocturia in men with BPH, yet the net advantage of terazosin over placebo was a net reduction of 0.3 nocturia episode. For a person to reach a 50% or greater reduction in nocturia, the advantage of terazosin over placebo was 17 percentage points. Changes in nocturia had a moderate impact on symptom specific quality of life measures.

Adrenergic alpha-Antagonists↗
PubMed2003

Nocturia and benign prostatic hyperplasia.

OBJECTIVES: To examine the frequency of and risk factors for nocturia in patients with symptomatic benign prostatic hyperplasia (BPH), and the degree of improvement of nocturia after treatment for BPH. METHODS: A total of 505 consecutively selected, newly diagnosed patients with symptomatic BPH were evaluated in studies examining frequency of and risk factors for nocturia. We analyzed the relationships between nocturia assessed by International Prostate Symptom Score (IPSS) and other parameters, including age, prostate volume, serum prostate-specific antigen level, and uroflow variables. Other studies examining the impact of conservative and invasive treatments on nocturia were also conducted using 165 patients receiving tamsulosin and 138 undergoing transurethral resection of the prostate (TURP). RESULTS: Overall, 359 of the 505 patients (71.1%) answered that they arose at least twice for urination at night. Patient age, score of urgency, and functional bladder capacity were each significantly associated with nocturia. Tamsulosin therapy and TURP significantly reduced the number of episodes of nocturia in 17.9% and 32.2% of patients, respectively. These rates of improvement were lowest for nocturia among the seven individual symptom scores. CONCLUSIONS: In this study using selected cohorts, the frequency of nocturia in patients with BPH was higher than that in community-based studies. Although we cannot estimate patients' satisfaction by the observed changes in scores, the rates of improvement were lowest for nocturia among the seven symptoms of IPSS after conservative and invasive treatments for BPH.

Adrenergic alpha-Antagonists↗
PubMed2004

Melatonin pharmacotherapy for nocturia in men with benign prostatic enlargement.

PURPOSE: Nocturia is a common condition often attributed in aging men to benign prostatic enlargement. Older adults are prone to nocturnal sleep disturbance, of which disturbed circadian rhythm may be a component since it improves with nighttime administration of melatonin. This study was designed to investigate melatonin as a potential treatment for nocturia associated with bladder outflow obstruction in older men. MATERIALS AND METHODS: A total of 20 men with urodynamically confirmed bladder outflow obstruction and nocturia were entered into a randomized, double blind, placebo controlled crossover study assessing the effect of 2 mg controlled release melatonin at night on nocturia. Symptoms were assessed at baseline and after each 4-week treatment period using a frequency volume chart, the International Prostate Symptom Score and symptom problem index. Maximum urinary flow rate and post-void residual urine volume were also assessed. RESULTS: Baseline frequency of nocturia was 3.1 episodes per night. There were 7 men (35%) with detrusor overactivity and 10 (50%) had nocturnal polyuria. Melatonin and placebo caused a decrease in nocturia of 0.32 and 0.05 episodes per night (p = 0.07) and a decrease in the nocturia bother score of 0.51 and 0.05, respectively (p = 0.008). Nocturia responder rates (a reduction from baseline of at least -0.5 episodes per night) differed between the active medication and placebo groups (p = 0.04). Daytime urinary frequency, International Prostate Symptom Score, relative nocturnal urine volume, maximum urinary flow rate and post-void residual were unaffected by melatonin treatment. CONCLUSIONS: Melatonin treatment is associated with a significant nocturia response rate, improvement in nocturia related bother and a good adverse effect profile. However, it is uncertain whether the observed changes in this study are clinically significant.

Aged↗
PubMed2004

Nocturia in patients with lower urinary tract symptoms: association with diurnal voiding patterns.

OBJECTIVE: To determine whether diurnal voiding patterns predict nocturia in patients with lower urinary tract symptoms (LUTS), as few studies have evaluated the association between diurnal and nocturnal voiding patterns. PATIENTS AND METHODS: We prospectively analysed the frequency-volume charts (FVCs) of consecutive patients with LUTS. At the initial visit patients had a detailed clinical evaluation and subsequently were requested to complete a 72-h FVC. In all, 104 (41 men and 63 women, mean age 63 years, range 50-83) were included in the primary analyses. Associations between daytime variables and nocturia were described using maximum likelihood estimates of the relative risk and by 95% confidence intervals (CIs) based on logistic regression models. RESULTS: When at least one night-time void was used to define nocturia the multivariate logistic model showed a negative association of mean daytime voided volume with nocturia (P = 0.001). The odds ratio for nocturia decreased with this variable to 0.98 (95% CI 0.96-0.99). When 'voiding at least twice per night' was used to define nocturia only the number of daytime voids was positively related to nocturia (odds ratio 1.22; 95% CI 1.01-1.48; P= 0.040). CONCLUSION: Nocturia may be associated with diurnal voiding patterns; these results also suggest that the causes of nocturia of one or of two or more voids may differ. This highlights the role of bladder function in more severe forms of nocturia.

Aged↗
PubMed1999

Sleep-disordered breathing as a mechanism for nocturia: preliminary findings.

Nocturia is commonly associated with prostate or bladder problems but is also an important symptom of obstructive sleep apnea, a potentially lethal condition. The primary purpose of this study was to test the relationship between symptoms of sleep-disordered breathing and increased nocturnal urine production as described by the Sleep-Disordered Breathing--Nocturia Model. The purpose of the first phase of this three-phase study was to survey community-dwelling older adults (> 55 years) about nocturia and sleep-disturbance symptoms. A random sample of 1,000 older adults, balanced by ethnicity and gender, were surveyed via a mailed questionnaire. The brief questionnaire included characterizing poor sleep quality, obstructive sleep apnea symptoms, nocturia, lower urinary tract symptoms, naps, and self-rated health. The return rate was low (18%, n = 176), but respondents were equally represented by gender and ethnicity across the targeted age groups. Half of the respondents (n = 87) reported > or = 2 voids per night, two-thirds of whom reported nocturia as bothersome. The data showed that African-American women had significant associations between episodes of nocturia and symptoms of obstructive sleep apnea, poor sleep quality, naps, and lower urinary tract symptoms, thus failing to support the notion that nocturia or sleep-disordered breathing are prostate or gender related. As expected, subjects (n = 80) who volunteered for the later phases of the study, had significantly more problems. These preliminary data suggest that the relationship between obstructive sleep apnea and nocturia is important because older adults are at higher risk of injury due to falls that may occur while attempting to toilet in the dark. Also, older adults may also be at higher risk of receiving inappropriate urologic treatment if they are not screened for sleep disorders when reporting nocturia along with symptoms of excessive daytime sleepiness and sleep-disordered breathing. Phases II and III of the parent study will include a detailed examination of hormonal, biochemical, and physical variables to further test the proposed Sleep-Disordered Breathing--Nocturia Model.

Aged↗
PubMed1996

Nocturia. A rarely recognized symptom of sleep apnea and other occult sleep disorders.

BACKGROUND: Nocturia, awakening from sleep to urinate, is a common symptom in a variety of medical disorders and in the elderly. Awakening from sleep as a result of nocturia is thought to be secondary to a sensation of urinary urgency resulting from an overextended bladder. Nocturia-related awakenings cause significant sleep disruption and fatigue in elderly patients and are correlated with an increased number of falls at night. Sleep disorders such as sleep apnea are also common in the elderly and are frequently the source of awakenings from sleep. The high incidence of both nocturia and sleep disorders in the elderly and other groups of patients suggests that sleep disorders may be the source of some awakenings from sleep usually attributed by patients to nocturia. Nocturia secondary to sleep disorders would be causatively different from nocturia secondary to pressure to urinate in common medical disorders and would require different diagnostic procedures and treatment. OBJECTIVE: To determine the frequency of nocturia as a symptom of primary sleep disorders. METHODS: Eighty consecutive patients, 27 women and 53 men with a mean (+/-SD) age of 58.7+/-14.1 years, undergoing polysomnography (sleep study or PSG) for the evaluation of a suspected sleep disorder and who met the sole criteria of awakening from sleep at least once and urinating voluntarily. Each patient had either a standard PSG recording or a PSG with administration of nasal continuous positive airway pressure. Immediately after each episode of nocturia during the PSG, patients were questioned about the reason they believed they had awakened. The PSG record immediately before awakening from sleep was then reviewed for potential causes of awakening. Patients were also asked on final morning awakening to fill in a questionnaire regarding their awakenings during the prior night. Patient reports were compared with the PSG to determine the accuracy of subjective reports. RESULTS: Patients awakened from sleep and voluntarily urinated a mean (+/- of 1.5+/-0.75 times per night for a total of 121 awakenings for the group. The majority (79.3%) of these awakenings from sleep were found to be directly secondary to sleep apnea, snoring or periodic leg movements in sleep. Patients correctly identified the source of their awakening from sleep on only five(4.9%) occasions and only once was sleep apnea correctly cited by a patient as a source of awakening during the night. CONCLUSION: Most awakenings from sleep attributed by our patients to pressure to urinate were instead a result of sleep disorders, particularly sleep apnea. The fact that patients do urinate once awake likely contributed to faulty post hoc reasoning and might have limited further inquiry by patients and their physicians in clinical settings into the actual sources of awakening from sleep. Even in those patients with well-known medical reasons for noctruria, Sleep disorders were still found to be the source of almost all awakenings from sleep. Patients were extremely poor judges of the reasons they awoke from sleep. The diagnosis of a sleep disorder should be seriously considered whenever a patient reports frequent awakenings from sleep to urinate.

Adult↗
PubMed2002

Nocturia in the Dutch adult population.

OBJECTIVE: To estimate the prevalence of nocturia in the Dutch adult population, its association with sociodemographic and health characteristics, and to assess problems experienced by persons with nocturia. SUBJECTS AND METHODS: In spring 2001 a telephone survey was conducted among a representative sample of 4721 Dutch respondents (response 53%). Using questions from the Bristol Lower Urinary Tract Symptoms questionnaire respondents were asked about having nocturia and the problems they experienced. In addition, questions were asked about sociodemographic and health characteristics. RESULTS: The prevalence of nocturia (a mean of twice or more/night) among Dutch men and women over 18 years old was 13%, standardized for age and sex. Women had nocturia more often than men (16% vs 9%) and the prevalence was positively associated with age, poor health status and use of medication. CONCLUSION: The prevalence of nocturia in Dutch men and women differs more than reported in earlier studies. The prevalence in the Netherlands seems slightly higher than in other Western countries, but Dutch persons with nocturia report fewer problems. Nocturia does not occur in isolation and is associated with sleep disturbances. It is worthwhile for general practitioners to routinely check whether patients who contact them for lower urinary tract symptoms or sleeping disorders have nocturia.

Adult↗
PubMed1998

Nocturia in adults: etiology and classification.

Nocturia is one of the most bothersome of all urologic symptoms, yet even a rudimentary classification does not exist. We herein propose a classification system of nocturia based on a retrospective study. The records of 200 consecutive patients with nocturia were reviewed. Evaluation included history, micturition diary (including day, night, and 24-hr voided volume), postvoid residual urine (PVR), and videourodynamic study (VUDS). Functional bladder capacity (FBC) was determined to be the largest voided volume in a 24-hr period. The etiology of nocturia was thus classified into one of three groups: nocturnal polyuria ([NP] in which voided urine volume during the hours of sleep exceeds 35% of the 24-hr output), nocturnal detrusor overactivity ([NDO] defined as nocturia attributable to diminished bladder capacity during the hours of sleep), and mixed (NP+NDO); polyuria (24-hr urine output >2,500 cc) was classified separately. There were 129 women and 65 men ranging in age from 17 to 94 years (x=59). Overall 13 (7%) had NP, 111 (57%) NDO, and 70 (36%) had a mixed etiology of their nocturia (both NP and NDO). Forty-five (23%) also had polyuria. These data confirm that the etiology of nocturia is multifactorial and in many instances unrelated to the underlying urologic condition. Nocturnal overproduction of urine is a significant component of nocturia in 43% of patients, most of whom will also have NDO. We believe that treatment should be directed at both conditions.

Adolescent↗
PubMed2004

A prospective study of nocturia and the quality of life of elderly patients with obstructive sleep apnea or sleep onset insomnia.

OBJECTIVE: To prospectively evaluate the relationship between obstructive sleep apnea syndrome (OSAS), nocturia and quality of life in elderly patients free of the urologic and medical conditions that lead to increased nocturia. METHODS: Prospective study of nocturia in men 65 years and older with isolated OSAS or sleep onset insomnia. After a 7-day nocturia evaluation and nocturnal polysomnography, Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI), Quality of Life (SF-36) were administered. RESULTS: OSAS patients with frequent nocturia had significantly greater body mass index (BMI), greater apnea-hypopnea index (AHI), lower lowest oxygen saturation and lower SF-36 subscale scores. Treatment with nasal continuous positive airway pressure (CPAP) for OSAS and behavioral techniques for insomnia improved ESS and BDI scores for all three groups. SF-36 subscale scores improved more in subjects with multiple nocturia. AHI and BMI explain 38% of the variance for nocturia. CONCLUSION: Nasal CPAP reduces OSA and nocturia and improves quality of life of elderly patients.

Aged↗
PubMed2000

Cross-sectional study of nocturia in both sexes: analysis of a voluntary health screening project.

OBJECTIVES: To assess the prevalence of nocturia and its impact on the quality of life in both sexes by analyzing almost 2500 individuals participating in a health survey. METHODS: During a 12-month period, we included an incontinence questionnaire, which was largely based on the Bristol female lower urinary tract symptoms questionnaire, in the voluntary health examinations in the area of Vienna. In parallel, we recorded the medical history, concurrent medical therapy, physical examination findings, sociodemographic parameters, and blood laboratory study results. RESULTS: The data of 1247 women (age 49.8 +/- 13.5 years) and 1221 men (age 48.5 +/- 11.9 years) were analyzed. The percentage of individuals with nocturia of two or more times increased constantly with age: less than 30 years, 3.1% of women and 3.4% of men; 30 to 59 years, 7.2% of women and 5. 7% of men; and 60 years old or older, 26.7% of women and 32.4% of men. Age-adjusted extrapolation to the general population (older than 20 years) currently living in Austria yielded that 10.8% of men and 11.8% of women have nocturia of two or more times. Overall, 66. 9% of women and 62.2% of men reported a negative impact of nocturia on their quality of life. The correlation was close between the degree of nocturia with the quality-of-life impairment in both sexes. Several voiding symptoms correlated significantly (P <0.001) with nocturia. CONCLUSIONS: Nocturia is almost equally present in both sexes, and the incidence and severity increase constantly from early adolescence to senescence. Approximately 10% of the general population (older than 20 years) have nocturia of two or more times, which impairs the quality of life in two thirds.

Adult↗
PubMed2001

Human atrial natriuretic peptide is a useful criterion in treatment of nocturia.

BACKGROUND: Nocturia is one of the major problems of elderly people. The possible causes of nocturia include irritation of lower urinary tract obstruction, disturbance of the fluid balance, and sleep disturbance. In a significant proportion of patients, the mechanism of nocturia is still unclear and a definitive method of treatment has yet to be determined. This study investigated how to treat nocturia. MATERIALS AND METHODS: We analyzed 51 patients who visited Kobe City General Hospital between January 1998 and June 1999 with nocturia (three or more nocturnal voidings) and no daytime urological problems. Twenty-two of these patients were given daytime diuretic therapy (azosemide 60 mg), while 29 other patients received a minor tranquilizer. The method of treatment was selected randomly. Correlations between the plasma level of atrial natriuretic peptide (hANP) and the effect of treatment were analyzed. RESULTS: Daytime diuretics decreased the nocturnal frequency of voiding in 10 out of 22 patients. The plasma hANP level at the first visit was significantly higher in the patients with improvement (p = 0.0026). Furthermore, the plasma hANP level was significantly decreased after daytime diuretic therapy in patients who showed improvement of nocturia with diuretic therapy (p = 0.0180). Minor tranquilizer administration decreased nocturia in 22 out of 29 patients. The plasma hANP level at the first visit was significantly lower in the patients who improved (p = 0.0021). CONCLUSIONS: These findings suggest that patients with higher plasma hANP levels should be treated as having subclinical heart failure, while nocturia in patients with a normal plasma hANP level might be caused by sleep disturbance.

Aged↗
PubMed2004

Prevalence of and risk factors for nocturia: Analysis of a health screening program.

BACKGROUND: We examined the prevalence of and risk factors for nocturia in Kurashiki city and the surrounding area, a rural area in Japan. MATERIALS AND METHODS: We collected data on 6517 individuals (4568 men and 1949 women) who participated in a multiphasic health screening. We analyzed the relationships between nocturia assessed by a questionnaire (voiding twice or more during night) and other variables including age, hypertension, cardiovascular disease, cerebrovascular disease, chronic obstructive pulmonary disease, diabetes mellitus (DM), chronic renal failure, benign prostatic hyperplasia (BPH), smoking habit and alcohol intake. RESULTS: Overall, 1856 individuals (28.5%) answered that they arose to urinate at least twice during the night. This rate increased with age from 16.5% in individuals younger than 50 to 60.0% in those older than 69. Logistic regression analysis revealed that cohorts of subjects 50-59, 60-69, and 70 years old or over had, respectively, 1.75, 3.35, and 6.21 times the prevalence of nocturia of the 49 years or younger cohort. Hypertension (odds ratio [OR] 1.64) and DM (OR 1.70) were other independent positive risk factors for nocturia. On the other hand, current smokers who smoked 20 or more cigarettes per day were less likely to have nocturia than non-smokers (OR 0.72). In male individuals, BPH was another independent positive risk factor (OR 1.35). Gender was not associated with nocturia. CONCLUSIONS: Although population bias is an important limitation to this study, nocturia is associated with various factors suggesting that multiple approaches are needed to the treatment of patients with nocturia.

Age Distribution↗
PubMed1992

Nocturia: a risk factor for falls in the elderly.

OBJECTIVE: To determine if nocturia is a risk factor for reported falls and bone fractures in older persons. DESIGN: Cross-sectional study comparing falls in men and women with and without nocturia. SETTING: Longitudinal health screening program of ambulatory elderly participants. PARTICIPANTS: Participants included 988 (65.5%) women and 520 (34.5%) men who had completed their tenth annual visit to the program. MAIN OUTCOME MEASURES: Reported falls in the past year and reported bone fractures in the past 5 years. RESULTS: Participants who reported nocturia at least twice during the night were at significantly greater risk to report falls (Odds Ratio = 1.84; 95% CI = 1.05-3.22), and the risk increased in subjects reporting more than three nocturia events (Odds Ratio = 2.15; 95% CI = 1.04-4.44). The significant increase in falls reported by nocturia participants did not result in an increase in reported bone fractures in the past 5 years (P < 0.4360). CONCLUSIONS: Nocturia is an important risk factor for falls in ambulatory elderly persons. Preventive measures should be taken to decrease nocturia events and to decrease the risk of falling during these nocturia events.

Accidental Falls↗
PubMed2004

Effectiveness of a nonsteroidal anti-inflammatory drug for nocturia on patients with benign prostatic hyperplasia: a prospective non-randomized study of loxoprofen sodium 60 mg once daily before sleeping.

We explored the effectiveness of loxoprofen sodium (loxoprofen), which is the most common non-steroidal anti-inflammatory drug (NSAID) in Japan, for patients with benign prostatic hyperplasia (BPH) complaining of nocturia. A total of 93 BPH patients aged 49-84 years were enrolled in the study. These patients had received standard drug therapy with alpha1-blocker for BPH, followed by anticholinergic drugs, hypnotics, tricyclic antidepressants, and/or antiduretic hormone, but they still complained about 2 or more episodes of nocturia. They each took a single 60-mg tablet of loxoprofen prior to sleeping at night for 14 days in addition to their BPH treatments. The effects were assessed by questionnaire before and after treatment as excellent (nocturia disappeared or decreased by 2 or more voids/night), improved (nocturia decreased by 1 void/night), unchanged, or worsened (nocturia increased). Nocturia improved or disappeared in 74.2% of patients: excellent, improved, unchanged, and worsened results were obtained in 37.6%, 36.6%, 21.5%, and 4.3% of patients, respectively. The effects were better in patients whose baseline nocturia was > 2 times than in those with a lesser frequency at enrollment (P = 0.04). Loxoprofen can be an effective and useful treatment option for patients with BPH complaining of refractory nocturia.

Aged↗
PubMed1996

Desmopressin in the management of nocturia in patients with multiple sclerosis. A double-blind, crossover trial.

BACKGROUND: Neurogenic bladder affects up to 80% of patients with multiple sclerosis (MS) and, in 50% of these patients, it is a significant cause of disability. The current management of neurogenic bladder, based on fluid restriction, anticholinergic agents, intermittent self-catheterization, and, in some cases, surgical intervention, often fails to relieve all symptoms. Furthermore, anticholinergic drugs have significant adverse effects and may be medically contraindicated. Nocturia is a particularly disabling symptom of neurogenic bladder; by disrupting sleep patterns, it aggravates the chronic fatigue of MS, imposes serious demands on caregivers, and can lead to institutionalization. To evaluate a novel approach to the symptomatic management of nocturia in patients with MS, we have conducted a trial of desmopressin acetate (1-desamino-8-D-arginine vasopressin), a synthetic analogue of antidiuretic hormone. OBJECTIVE: To evaluate the efficacy and short-term safety of desmopressin therapy in the symptomatic treatment of nocturia in patients with MS. METHODS: Seventeen patients were enrolled in a double-blind, crossover trial of desmopressin administered at bedtime. Patients with both relapsing-remitting and chronic-progressive forms of MS were admitted. Night time voiding diaries were maintained for the 6 weeks of the trial; similarly, serum electrolyte levels and plasma osmolality were measured twice weekly and urinalyses and urine cultures were performed weekly during the trial. RESULTS: Desmopressin reduced the percentage of nights with nocturia in patients from 97% to 66%. The average number of episodes of nocturia per night in patients decreased from 2.35 to 1.09 and the maximum hours of sleep uninterrupted by nocturia increased from 3.74 to 5.77. These results were highly significant. Four of the 17 patients discontinued participation in the study after developing asymptomatic or minimally symptomatic hyponatremia. CONCLUSIONS: Desmopressin was found effective; no tolerance and only minimal adverse effects have been observed. Our results suggest that desmopressin, either alone or in combination with other therapeutic modalities, is effective in the symptomatic management of nocturia in patients with MS. The only adverse effect attributed to desmopressin was hyponatremia, which occurred in 4 of 17 patients and appeared to be dose related.

Adult↗