Skip to main content

Advertisement

SpringerLink
Log in

Impact of desmopressin on nocturia due to nocturnal polyuria in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH)

  • Topic Paper
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the efficacy of desmopressin on nocturia, quality of sleep (QoS), and health-related quality of life (HRQoL) in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) and nocturia due to nocturnal polyuria (NP) as the predominant symptom.

Methods

A German observational, multicenter, post-marketing surveillance study including men with LUTS/BPH and nocturia due to NP starting 3 months of desmopressin treatment.

Results

In total, 137 patients with a mean of 3.8 nocturnal voids (range 2–7) were included. Desmopressin significantly reduced the mean number of nocturnal voids by 53 %, mean IPSS nocturia question by 50 %, and the mean ratio of night/24-h urine volume by 39 % from baseline to endpoint. The hours of undisturbed sleep significantly increased by 74 %; 71 % of men reported about undisturbed sleep of ≥4 h at study end. Additionally, there was a significant reduction in the Leeds Sleep Evaluation Questionnaire score, indicating a clinically relevant QoS improvement. This was associated with an improved HRQoL, as shown by a significant improvement in both the mean IPSS-QoL question by 43 % and mean ICIQ-N nocturia problem question by 53 %. Concomitant alpha-blocker use had no effect on the efficacy of desmopressin. The incidence of adverse events was low (2.2 %). Hyponatremia was not observed in any patient. The majority of patients and physicians rated the efficacy and tolerability of desmopressin as good/very good.

Conclusions

Desmopressin is an effective and well-tolerated treatment for nocturia due to NP in patients with LUTS/BPH in daily practice under routine conditions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. van Kerrebroeck P, Abrams P, Chaikin D, Donovan J, Fonda D, Jackson S, Jennum P, Johnson T, Lose G, Mattiasson A, Robertson G, Weiss J (2002) The standardisation of terminology in nocturia: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21(2):179–183

    Article  PubMed  Google Scholar 

  2. Tikkinen KA, Johnson TM 2nd, Tammela TL, Sintonen H, Haukka J, Huhtala H, Auvinen A (2010) Nocturia frequency, bother, and quality of life: how often is too often? A population-based study in Finland. Eur Urol 57(3):488–496

    Article  PubMed  Google Scholar 

  3. Weiss JP, Blaivas JG, Bliwise DL, Dmochowski RR, Dubeau CE, Lowe FC, Petrou SP, Van Kerrebroeck PE, Rosen RC, Wein AJ (2011) The evaluation and treatment of nocturia: a consensus statement. BJU Int 108(1):6–21

    Article  PubMed  Google Scholar 

  4. Oelke M, Wiese B, Berges R (2014) Nocturia and its impact on health related quality of life and health care seeking behaviour in German community-dwelling men aged 50 years or older. World J Urol. doi:10.1007/s00345-014-1374-6

  5. van Kerrebroeck P (2002) Standardization of terminology in nocturia: commentary on the ICS report. BJU Int 90(Suppl 3):16–17

    Article  PubMed  Google Scholar 

  6. Rembratt A, Norgaard JP, Andersson KE (2003) Nocturia and associated morbidity in a community-dwelling elderly population. BJU Int 92(7):726–730

    Article  PubMed  CAS  Google Scholar 

  7. Chang SC, Lin AT, Chen KK, Chang LS (2006) Multifactorial nature of male nocturia. Urology 67(3):541–544

    Article  PubMed  Google Scholar 

  8. Stanley N (2005) The physiology of sleep and the impact of ageing. Eur Urol Suppl 3:17–23

    Google Scholar 

  9. Abrams P (2005) Nocturia: the effect on sleep and related health consequences. Eur Urol Suppl 3:1–7

    Article  Google Scholar 

  10. Asplund R (2005) Nocturia: consequences for sleep and daytime activities and associated risks. Eur Urol Suppl 3:24–32

    Article  Google Scholar 

  11. Dijk DJ, Groeger JA, Stanley N, Deacon S (2010) Age-related reduction in daytime sleep propensity and nocturnal slow wave sleep. Sleep 33(2):211–223

    PubMed  PubMed Central  Google Scholar 

  12. Akerstedt T, Nilsson PM (2003) Sleep as restitution: an introduction. J Intern Med 254:6–12

    Article  PubMed  CAS  Google Scholar 

  13. Asplund R (1999) Mortality in the elderly in relation to nocturnal micturition. BJU Int 84(3):297–301

    Article  PubMed  CAS  Google Scholar 

  14. Bonnet MH, Arand DL (2003) Clinical effects of sleep fragmentation versus sleep deprivation. Sleep Med Rev 7:297–310

    Article  PubMed  Google Scholar 

  15. Abrams P (2005) Nocturia: the major problem in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction (LUTS/BPO). Eur Urol Suppl 3:8–16

    Article  Google Scholar 

  16. van Kerrebroeck P (2011) Nocturia: current status and future perspectives. Curr Opin Obstet Gynecol 23(5):376–385

    PubMed  Google Scholar 

  17. Oelke M, Bachmann A, Descazeaud A, Emberton M, Gravas S, Michel MC, N’Dow J, Nordling J, de la Rosette JJ (2013) EAU guidelines on the treatment and follow-up of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. Eur Urol 64(1):118–140

    Article  PubMed  Google Scholar 

  18. Eisenhardt A, Schneider T, Cruz F, Oelke M (2014) Consistent and significant improvement of nighttime voiding frequency (nocturia) with silodosin in men with LUTS suggestive of BPH: pooled analysis of three randomized, placebo-controlled, double-blind phase III studies. World J Urol. doi:10.1007/s00345-013-1228-7

    PubMed  Google Scholar 

  19. Oelke M, Roehrborn CG, D’Ancona C, Wilson TH, Castro R, Manyak M (2014) Nocturia improvement in the combination of Avodart and tamsulosin (CombAT) study. World J Urol. doi:10.1007/s00345-014-1296-3

    Google Scholar 

  20. Oelke M, Roehrborn CG, D’Ancona C, Wilson TH, Castro R, Manyak M (2014) Nocturia improvement with dutasteride in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH): a pooled analysis of three phase III studies. World J Urol. doi:10.1007/s00345-014-1316-3

    Google Scholar 

  21. Oelke M, Weiss JP, Mamoulakis C, Cox D, Ruff D, Viktrup L (2014) Effects of tadalafil on nighttime voiding (nocturia) in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia: a post hoc analysis of pooled data from four randomized, placebo-controlled clinical studies. World J Urol. doi:10.1007/s00345-014-1255-z

    Google Scholar 

  22. Oelke M, Berges R, Schlafke S, Burkart M (2014) Fixed-dose combination PRO 160/120 of sabal and urtica extracts improves nocturia in men with LUTS suggestive of BPH: re-evaluation of four controlled clinical studies. World J Urol. doi:10.1007/s00345-014-1338-x

    Google Scholar 

  23. Andersson KE, Appell R, Cardozo L (2005) Pharmalogical treatment of urinary incontinence. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence. 3rd international consultation on incontinence. Health Publication Ltd, Paris, pp 809–854

    Google Scholar 

  24. Fonda D, DuBeau C, Harari D, Ouslander JG, Palmer M, Roe B (2005) Incontinence in the frail elderly. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence (3rd international consultation on incontinence. Health Publication Ltd, Paris, pp 1163–1240

    Google Scholar 

  25. Mattiasson A, Abrams P, van Kerrebroeck P, Walter S, Weiss J (2002) Efficacy of desmopressin in the treatment of nocturia: a double-blind placebo-controlled study in men. BJU Int 89(9):855–862

    Article  PubMed  CAS  Google Scholar 

  26. van Kerrebroeck P, Rezapour M, Cortesse A, Thüroff J, Riis A, Norgaard JP (2007) Desmopressin in the treatment of nocturia: a double-blind, placebo-controlled study. Eur Urol 52(1):221–229

    Article  PubMed  Google Scholar 

  27. Lose G, Mattiasson A, Walter S, Lalos O, van Kerrebroeck P, Abrams P, Freeman R (2004) Clinical experiences with desmopressin for long-term treatment of nocturia. J Urol 172(3):1021–1025

    Article  PubMed  CAS  Google Scholar 

  28. Barry MJ, Fowler FJ Jr, O’Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK (1995) Measuring disease-specific health status in men with benign prostatic hyperplasia. Measurement Committee of the American Urological Association. Med Care 33(4 Suppl):AS145–AS155

  29. Rodrigues P, Meller A, Campagnari JC, Alcantara D, D’Imperio M (2004) International Prostate Symptom Score–IPSS-AUA as discriminant scale in 400 male patients with lower urinary tract symptoms (LUTS). Int Braz J Urol 30(2):135–141

    Article  PubMed  Google Scholar 

  30. McKown S, Abraham L, Coyne K, Gawlicki M, Piault E, Vats V (2010) Linguistic validation of the N-QOL (ICIQ), OAB-q (ICIQ), PPBC, OAB-S and ICIQ-MLUTSsex questionnaires in 16 languages. Int J Clin Pract 64(12):1643–1652

    Article  PubMed  CAS  Google Scholar 

  31. Parrott AC, Hindmarch I (1980) The Leeds Sleep Evaluation Questionnaire in psychopharmacological investigations—a review. Psychopharmacology 71(2):173–179

    Article  PubMed  CAS  Google Scholar 

  32. Meadows R, Venn S, Hislop J, Stanley N, Arber S (2005) Investigating couples’ sleep: an evaluation of actigraphic analysis techniques. J Sleep Res 14(4):377–386

    Article  PubMed  CAS  Google Scholar 

  33. Lose G, Lalos O, Freeman RM, van Kerrebroeck P, Nocturia Study Group (2003) Efficacy of desmopressin (Minirin) in the treatment of nocturia: a double-blind placebo-controlled study in women. Am J Obst Gynecol 189(4):1106–1113

  34. Vande Walle J, Stockner M, Raes A, Norgaard JP (2007) Desmopressin 30 years in clinical use: a safety review. Curr Drug Saf 2:232–238

    Article  PubMed  CAS  Google Scholar 

  35. Juul KV, Klein BM, Sandstrom R, Erichsen L, Norgaard JP (2011) Gender difference in antidiuretic response to desmopressin. Am J Physiol Renal Physiol 300(5):F1116–F1122

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This study was supported by an unconditional educational grant of FERRING GmbH which had no influence on the content of this publication. The authors would like to thank Dr. Jörg Schnitker, Institute for Statistics, Bielefeld, Germany for biometrical evaluation of the study data and the participating physicians for including their patients into this study and careful data collection.

Conflict of interest

Richard Berges is a lecturer, advisor and/or study participant in the field of LUTS/BPH for Astellas, GlaxoSmithKline, Ferring, Lilly, Pfizer, and Recordati. Klaus Höfner is a lecturer, advisor and/or study participant in the field of LUTS/BPH for Astellas, GlaxoSmithKline, Ferring, and Lilly. Michael Gedamke is employee of Ferring Arzneimittel GmbH in Germany. Matthias Oelke is a lecturer, advisor and/or study participant in the field of LUTS/BPH for Apogepha, Astellas, Biocompatibles, GlaxoSmithKline, Ferring, Lilly, Mundipharma, Pfizer, and Recordati.

Ethical standard

Ethics committee approval (study number FE992026_CS33) and written informed consent were obtained from all study participants. The study was designed and performed according to the German GCP recommendations and the 1964 Declaration of Helsinki.

Author information

Authors and Affiliations

  1. PAN-Klinik am Neumarkt, Cologne, Germany

    Richard Berges

  2. Evangelisches Krankenhaus, Oberhausen, Germany

    Klaus Höfner

  3. Ferring Arzneimittel GmbH, Kiel, Germany

    Michael Gedamke

  4. Department of Urology, OE 6240, Hannover Medical School, 30625, Hannover, Germany

    Matthias Oelke

Authors
  1. Richard Berges
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Klaus Höfner
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael Gedamke
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Matthias Oelke
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Matthias Oelke.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Berges, R., Höfner, K., Gedamke, M. et al. Impact of desmopressin on nocturia due to nocturnal polyuria in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH). World J Urol 32, 1163–1170 (2014). https://doi.org/10.1007/s00345-014-1381-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-014-1381-7

Keywords

Search

Navigation