Korean J Urol.  2013 Feb;54(2):95-99.

Influence of Type of Nocturia and Lower Urinary Tract Symptoms on Therapeutic Outcome in Women Treated With Desmopressin

• Jeong JY
• Kim SJ
• Cho HJ
• Hong SH
• Lee JY
• Hwang TK
• Kim SW

Abstract

PURPOSE
To investigate the type of nocturia and concomitant voiding dysfunction (VD) and the effect of desmopressin treatment on nocturia in women.
MATERIALS AND METHODS
We reviewed 84 women who experienced more than 2 nocturia episodes as recorded on a pretreatment frequency volume chart and who were treated with desmopressin. All patients underwent history taking, physical examination, urinalysis, International Prostate Symptom Score assessment, completion of a urinary sensation scale, and completion of a 3 day frequency volume chart. Nocturia was divided into nocturnal polyuria (NP), reduced nocturnal bladder capacity (RNBC), and mixed type. After treatment with desmopressin, a reduction in nocturia of over 50% compared with baseline was regarded as effective.
RESULTS
Among 84 women, the most common concomitant VD was overactive bladder (OAB, 60.7%). NP was observed in 70.2% (59/84) of the women, RNBC in 7.1% (6/84), and mixed type in 22.6% (19/84). After medication with desmopressin, 73 women (86.9%) showed a significantly reduced number of nocturia episodes (1.4+/-1.5) compared with baseline (3.7+/-1.3, p<0.05). Eleven women (13.1%) did not show improvement. Of the 73 women who showed improvement, 41 women showed a reduction of more than 50% over baseline, and these women had a lower baseline urgency grade.
CONCLUSIONS
In the majority of women, nocturia coexisted with other VD such as OAB. Treatment with desmopressin effectively reduced the nocturia. However, other lower urinary tract symptoms (LUTS) such as urgency may reduce the effect of desmopressin. Therefore, consideration of concomitant LUTS seems to be necessary to increase the treatment effect of desmopressin on nocturia in women.

Keyword

Deamino arginine vasopressin; Lower urinary tract symptoms; Nocturia; Women

MeSH Terms

Deamino Arginine Vasopressin
Female
Humans
Lower Urinary Tract Symptoms
Nocturia
Physical Examination
Polyuria
Prostate
Sensation
Urinalysis
Urinary Bladder
Urinary Bladder, Overactive
Deamino Arginine Vasopressin

Figure

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  FIG. 1 Outcomes after medication with desmopressin 0.1 or 0.2 mg in women with nocturia. a:p<0.05 compared with non responder.

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  FIG. 2 Comparison of lower urinary tract symptoms between the women showed more than 50% reduction of nocturia (effectiveness) and women showed reduction of nocturia but not more than 50% (improvement). IPSS, International Prostate Symptom Scores. Urgency grade was evaluated by use of a urinary sensation scale. a:p<0.05 compared with women showed reduction of nocturia but not more than 50%.

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