Abstract
To determine whether participants in the behavior enhances drug reduction of incontinence (BE-DRI) trial experienced reduction in the frequency of nocturia and/or nocturnal leakage during treatment with antimuscarinic phamacotherapy with or without additional behavioral therapy. We analyzed urinary diary data relating to nocturia and nocturnal incontinence before and after 8 weeks of study treatment in the BE-DRI trial, in which patients were randomly assigned to receive drug therapy with tolterodine tartrate extended-release capsules 4 mg alone or in combination with behavioral training. Chi-square tests assessed whether nocturia and nocturnal incontinence prevalence varied by treatment arm and paired t tests assessed the change in mean frequency of nocturia and nocturnal leakage. Among 305 women, 210 (69%) had an average of at least one nocturia episode at baseline. There were small but statistically significant differences (p < 0.001) in mean nocturia frequency and nocturnal incontinence frequency with both treatments after 8 weeks, but no significant difference between study treatment groups. Among these urge incontinent women, tolterodine with or without supervised behavioral therapy had little impact on either nocturic frequency or nocturnal incontinence.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
van Kerrerebroeck PAP, Chaikin D et al (2002) The standardisation of terminology in nocturia: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21:179–183
Asplund R, Aberg HE (2000) Nocturia and health in women aged 40–64 years. Maturitas 35:143–148
FitzGerald MP, Litman HJ, Link CL, McKinlay JB, for the BACH Survey Investigators (2007) The association of nocturia with cardiac disease, diabetes, body mass index, age and diuretic use: results from the Boston Area Community Health (BACH) survey. J Urol 177:1385–1389
Coyne KS, Zhou Z, Battacharyya SK, Thompson CL, Dhawan R, Versi E (2003) The prevalence of nocturia and its effect on health-related quality of life and sleep in a community sample in the USA. BJU Int 92:948
Asplund R, Aberg H (1992) Health of the elderly with regard to sleep and nocturnal micturition. Scand J Prim Health Care 10:98–104
van Balen RSE, Polder JJ et al (2001) Hip fracture in elderly patients: outcomes for function, quality of life, and type of residence. Clin Orthopsedics and Relat Res 390:232–243
Asplund R (2006) Hip fractures, nocturia, and nocturnal polyuria in the elderly. Arch Gerontol Geriatr 43:319–326
Asplund R (2007) Pharmacotherapy for nocturia in the elderly patient. Drugs Aging 24:325–343
Johnson TM, Burgio KL, Reden DT, Wright KC, Goode PS (2005) Effects of behavioral and drug therapy on nocturia in older incontinent women. J Am Geriatr Soc 53:846–850
The Urinary Incontinence Treatment Network (2007) Design of the behavior enhances drug reduction of incontinence (BE-DRI) study. Contemporary Clinical Trials 28:48–58
Burgio KL, Kraus SR, Menefee S, Borello-France D, Corton M, Johnson HW, Mallett V, Norton P, FitzGerald MP, Dandreo KJ, Richter HE, Rozanski T, Albo M, Zyczynski HM, Lemack GE, Chai TC, Khandwala S, Baker J, Brubaker L, Stoddard AM, Goode PS, Nielsen-Omeis B, Nager C, Kenton K, Tennstedt SL, Kusek JW, Chang TD, Nyberg LM, Steers W for the Urinary Incontinence Treatment Network. (2008) Behavioral therapy to enable women with urge incontinence to discontinue drug treatment: a randomized trial. Ann Intern Med 149:161–169
Diokno AC, Brock BM, Brown MB, Herzog AR (1986) Prevalence of urinary incontinence and other urological symptoms in the noninstitutionalized elderly. J Urol 136:1022–1025
Lowenstein L, Brubaker L, Kenton K, Kramer H, Shott S, FitzGerald MP (2007) Prevalence and impact of nocturia in a urogynecologic population. Int Urogynecol J 18:1049–1052
Weiss JP, Blaivas JG, Jones M, Wang JT, Guan Z, 037 Study Group (2007) Age related pathogenesis of nocturia in patients with overactive bladder. J Urol 178:548–551
Brubaker L, FitzGerald MP (2007) Nocturnal polyuria and nocturia relief in patients treated with solifenacin for overactive bladder symptoms. Int Urogyn J 18:737–741
Rackley R, Weiss JP, Rovner ES, Wang JT, Guan Z, 037 Study Group (2006) Nighttime dosing with tolterodine reduces overactive bladder-related nocturnal micturitions in patients with overactive bladder and nocturia. Urology 67:731–736
Acknowledgements
Supported by cooperative agreements (U01 DK58225, U01 DK58229, U01 DK58234, U01 DK58231, U01 DK60379, U01 DK60380, U01 DK60393, U01 DK60395, U01 DK60397, and U01 DK60401) with the National Institute of Diabetes and Digestive and Kidney Diseases and by the National Institute of Child Health and Human Development and Office of Research in Women’s Health of the National Institutes of Health.
Conflicts of interest
MP FitzGerald has received research funding from and has provided consultation to Pfizer Inc and Astellas. Dr Lemack is lecturer for Astellas, Allergan, Pfizer, Novartis, and Indevus, has received research funding from Allergan, and has provided consultation to Allergan, Pfizer, and Novartis.
Author information
Authors and Affiliations
Consortia
Corresponding author
Rights and permissions
About this article
Cite this article
FitzGerald, M.P., Lemack, G., Wheeler, T. et al. Nocturia, nocturnal incontinence prevalence, and response to anticholinergic and behavioral therapy. Int Urogynecol J 19, 1545–1550 (2008). https://doi.org/10.1007/s00192-008-0687-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00192-008-0687-7