Department of General Surgery and Surgical Specialties, University of Modena and Reggio Emilia, Modena (MO), Italy.
Second Opinion Medical Network, Modena (MO), Italy.
Int J Clin Pract. 2020 Nov;74(11):e13612. doi: 10.1111/ijcp.13612. Epub 2020 Sep 7.
We designed a retrospective, monocentric, observational study to assess the efficacy and short-term side effect profile of desmopressin, a synthetic analogue of antidiuretic hormone, in 42 elderly patients affected by nocturnal polyuria (NP), a subset of nocturia (nocturnal overproduction of urine at night), which is characterised by nocturnal urine volume (NVU) exceeding 33% of the 24-hours total urine output.
The subjects had NP and included 25 males, which had benign prostatic hyperplasia (12 out of 25 had been surgically or endoscopically operated) and 15 females that had increased urinary frequency, night-time voiding, loss of bladder control and recurrent bladder infections, due to perineal wall weakness and vaginal or bladder prolapse. Patients recorded the number of voids during waking hours using a digital continuous urine meter. The quality of life (QoL) and efficacy of desmopressin were assessed at baseline and 12 weeks after treatment using the International Consultation on Incontinence Questionnaire Nocturia Quality of Life Module (ICIQ-Nqol) and International Prostate Symptom Score questionnaire (IPPS-Q8). The dosage of desmopressin acetate varied according to the discretion of the physician, usually beginning with one tablet before going to bed at night for 3 months. The dose was increased at 1-week intervals if a reduction in the NVU or night-time frequency was not achieved.
We found that desmopressin treatment reduced the nocturnal voided volume (P < .0001), ICIQ-Nqol (P < .0001) and IPPS-Q8 (P < .0001). No significant serum sodium alterations or modifications in serum creatine, potassium, or body weight were observed in all the patients. No adverse effects were observed.
Our findings show efficacy of desmopressin in the elderly for NP treatment supporting further clinical trials in larger cohorts of patients.
我们设计了一项回顾性、单中心、观察性研究，以评估去氨加压素（一种抗利尿激素的合成类似物）在 42 名受夜间多尿（NP）影响的老年患者中的疗效和短期副作用概况，NP 是夜间多尿（夜间尿液过度产生）的一个亚组，其特征是夜间尿量（NVU）超过 24 小时总尿量的 33%。
研究对象为 NP 患者，包括 25 名男性，其中 12 名因良性前列腺增生症（25 名中有 12 名接受过手术或内镜治疗）和 15 名女性因会阴部壁薄弱和阴道或膀胱脱垂而出现尿频、夜间排尿、膀胱控制丧失和复发性膀胱感染，记录使用数字连续尿液计在清醒时的排尿次数。在治疗前和治疗后 12 周，使用国际尿失禁咨询问卷夜间尿失禁生活质量模块（ICIQ-Nqol）和国际前列腺症状评分问卷（IPPS-Q8）评估生活质量（QoL）和去氨加压素的疗效。去氨加压素醋酸盐的剂量根据医生的判断而有所不同，通常从每晚睡前服用一片开始，持续 3 个月。如果 NVU 或夜间频率没有降低，则每隔一周增加一次剂量。
我们发现去氨加压素治疗降低了夜间排空量（P<0.0001）、ICIQ-Nqol（P<0.0001）和 IPPS-Q8（P<0.0001）。所有患者的血清钠均无显著改变，血清肌酐、钾或体重也无改变。未观察到不良反应。
我们的研究结果表明去氨加压素对老年 NP 患者有效，支持在更大的患者队列中进行进一步的临床试验。
