Efficacy of Desmopressin in Treatment of Adult Nocturia

Nam, Sang Gan; Moon, Du Geon; Kim, Je Jong

Abstract

PURPOSE: This study was performed to investigate the effect of desmopressin on nocturia in patients with irritative symptom who do not respond effectively to first line therapy, such as benign prostatic hyperplasia(BPH) medication(alpha-blocker and finasteride), antimuscarinics or calcium antagonist.
MATERIALS AND METHODS
Patients had been treated for unresolved severe nocturia(<3 times per night) in spite of first-line therapy for more than 3 months. Additional medication of desmopressin was recommended to the patients with unresolved nocturia in spite of first line therapy. According to clinical diagnosis, the patients were classified into three groups: Group I of male with BPH, Group II of male without BPH and Group III of female. The response to each first-line therapy and desmopressin treatment was estimated by the number of nocturia and quality of life. Additionally, before and after desmopressin treatment, voiding diary and urodynamic study were evaluated, respectively.
RESULTS
A total of 79 patients were enrolled in this study. Severe nocturia patients unresolved to 1st line therapy were improved after combination therapy of 1st line therapy with desmopressin. In 66(83.5%) of the total 78 patients, the number of nocturia was significantly reduced to less than 3 after combination therapy. According to groups, the number of nocturia was significantly reduced to less than 3 in 84.8% of Group I(n=46), 71.4% of Group II(n=21), and 100% of Group III(n=12), respectively.
CONCLUSIONS
Combination therapy with desmopressin effectively reduced nocturia in patients with unresolved severe nocturia in spite of first line treatment. We recommend combination therapy of desmopressin with first line treatment for unresolved severe nocturia in adults. Long term efficacy and adverse effects should be assessed for the generalized use of desmopressin.