口服Desmopressin對非夜間多尿型夜尿症在老年男性的臨床應用
趙浩堅1、陳順郎1,2、歐宴泉3
1中山醫學大學附設醫院泌尿科,
2中山醫學大學醫學院;
3台中榮民總醫院外科部泌尿科
Comparison of Nocturia Response to Desmopressin Treatment in Elderly Men with and without Nocturnal Polyuria in Real Life Practice
Hao-chien Chao1、Sung-Lang Chen1,2、Yen-Chuan Ou3
1Department of Urology, Chung Shan Medical university Hospital, Taichung, Taiwan,
2School of Medicine, Chung Shan Medical University, Taichung, Taiwan;
3Division of Urology, Department of Surgery, Taichung Veterans General Hospital Taichung, Taiwan
Purpose:
To evaluate the safety and efficacy of low dose desmopressin in elderly men with and without nocturnal polyuria (NP) in real life practice.
Materials and Methods:
Patients with lower urinary tract symptoms (LUTS)/ benign prostate hyperplasia (BPH) who were≧65years old with refractory nocturia were enrolled in this study. We retrospectively analyzed elderly men treated with adding desmopressin to current medications for nocturia according to category of the baseline nocturnal urine volume. The 48 frequency volume chart (FVC), International Prostate Symptom Score (IPSS) and quality of life (QoL) were initially assessed and re-evaluated 12 weeks later. Serum sodium level was checked 1 week, 4 weeks, and 12 weeks after initiation of desmopressin therapy or suspected hyponatremia event. The mean change in numbers of nocturnal voids was evaluated for efficacy of treatment.
Results:
A total of 136 patients were included with 55 in non-NP group and 81 in NP group. Hypertension was more common in NP group in regard of co-morbidities. During treatment period, there were significant reductions of nocturnal voids from 4.22 ± 1.38 to 2.31 ± 0.98 (p< 0.001) in non-NP group and from 4.52± 1.23 to 2.07 ± 0.89 (p< 0.001) in NP group. The reduction in nocturnal voids was more significant in NP group (2.44±1.15 vs 1.91±1.48 p=0.003). The mean decrease in serum sodium levels were 3.89 ± 1.22 mmol/L (p< 0.001) in non-NP group and 4.69 ±3.5 mmol/L (p< 0.001) in NP group at the extreme value.
Conclusion:
Long-term treatment with low-dose desmopressin is safe and effective for nocturia with or without NP in elderly patients with LUTS/BPH during real life practice. Patients should be well informed about the disease and are closely followed.