Investig Clin Urol.  2022 Sep;63(5):499-513. 10.4111/icu.20220165.

Korean guideline of desmopressin for the treatment of nocturia in men

Affiliations
  • 1Department of Urology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
  • 2Department of Urology, Daegu Catholic University School of Medicine, Daegu, Korea
  • 3Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, Korea
  • 4Yonsei Wonju Medical Library, Yonsei University Wonju College of Medicine, Wonju, Korea
  • 5Department of Urology, College of Medicine, Hallym University, Seoul, Korea
  • 6Department of Urology, Kwangju Christian Hospital, Gwangju, Korea
  • 7Department of Urology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
  • 8Department of Urology, Inje University College of Medicine, Seoul, Korea
  • 9Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea
  • 10Center of Evidence Based Medicine, Institute of Convergence Science, Yonsei University, Seoul, Korea

Abstract

Purpose
Nocturia is the most bothersome of lower urinary tract symptoms in men. Desmopressin, a synthetic analog of the human hormone vasopressin, has been used for the treatment of nocturia. However, the guidelines include varying recommendations for the use of desmopressin for the management of nocturia in men. Therefore, the Korean Urological Association (KUA) developed recommendations for desmopressin for the treatment of nocturia in men.
Materials and Methods
A rigorous systematic review was performed and Grading of Recommendations, Assessment, Development, and Evaluation methodology was used to rate the certainty of evidence for patient outcomes and to develop the evidence into recommendations. The steering group, guidelines development group, systematic review team, and external review group consisted of members of the Korean Continence Society, Korean Society of Geriatric Urological Care, and KUA, respectively, who were involved in the guidelines development process.
Results
The guidelines address the benefits, harms, patients’ values and preferences, costs, and resources related to desmopressin by using a single clinical question: What is the effectiveness of desmopressin compared to that of placebo, behavior modification, or other pharmacological therapies?
Conclusions
The guidelines development panel suggests desmopressin for men with nocturia instead of placebo, behavior modification, or alpha-blocker monotherapy (low certainty of evidence, weak recommendation). Additionally, the panel suggests desmopressin combination therapy with alpha-blockers for men with nocturia instead of alpha-blocker monotherapy or alpha-blocker combination therapy with anticholinergic agents (low certainty of evidence, weak recommendation).

Keyword

Deamino arginine vasopressin; GRADE approach; Guideline; Men; Nocturia
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