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Kurose H, Ueda K, Chikui K, Uemura K, Nishihara K, Nakiri M, Suekane S, Igawa T. Effects of long-term desmopressin treatment for nocturia in older people. Int J Urol 2024. [PMID: 39007527 DOI: 10.1111/iju.15530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 06/24/2024] [Indexed: 07/16/2024]
Abstract
OBJECTIVES Desmopressin improves nocturia frequency; however, reports on its long-term efficacy and safety are few, and concerns regarding its effect on body composition exist. We thus investigated the efficacy and safety of long-term desmopressin administration and its effect on body composition. METHODS This retrospective study, conducted at Chikugo City Hospital between August 2020 and December 2022, involved 133 men (mean age, 77.7 years) with nocturnal and persistent nocturia, who were administered an initial dose of 50 μg desmopressin. Efficacy endpoints included nocturnal urinary frequency, nocturnal urinary volume, hours of undisturbed sleep, nocturnal polyuria index, initial nocturnal urinary volume, and daily urinary frequency in a frequency-volume chart (3 days), before treatment and at 1, 4, 12, 24, and 52 weeks after desmopressin administration. Additionally, the effects of desmopressin on body composition were examined, including blood-brain natriuretic peptide and a chest radiography, before and 52 weeks after administration. RESULTS Treatment improved most efficacy endpoint evaluation parameters. Around 87.6% of patients showed improved symptoms after 52 weeks compared with those before treatment (score ≤ 3). The blood-brain natriuretic peptide level rose; however, cardiothoracic ratio was unchanged. CONCLUSION Long-term administration of desmopressin is thus effective and safe in older people with nocturnal polyuria, with little effect on body composition.
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Affiliation(s)
- Hirofumi Kurose
- Department of Urology, Chikugo City Hospital, Chikugo, Fukoka, Japan
- Department of Urology, Kurume University School of Medicine, Kurume, Fukoka, Japan
| | - Kosuke Ueda
- Department of Urology, Kurume University School of Medicine, Kurume, Fukoka, Japan
| | - Katsuaki Chikui
- Department of Urology, Kurume University School of Medicine, Kurume, Fukoka, Japan
| | - Keiichiro Uemura
- Department of Urology, Kurume University School of Medicine, Kurume, Fukoka, Japan
| | - Kiyoaki Nishihara
- Department of Urology, Kurume University School of Medicine, Kurume, Fukoka, Japan
| | - Makoto Nakiri
- Department of Urology, Kurume University School of Medicine, Kurume, Fukoka, Japan
| | - Shigetaka Suekane
- Department of Urology, Kurume University School of Medicine, Kurume, Fukoka, Japan
| | - Tsukasa Igawa
- Department of Urology, Kurume University School of Medicine, Kurume, Fukoka, Japan
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Liu Y, Zhang Z, Huijie Hu, He X, Xu P, Qifeng Dou, Song C, Zhang H, Franco I, Kamperis K, Rittig S, Jianguo Wen. Prevalence and relevant factors of nocturia and its impact on sleep quality in Chinese university students. Sci Rep 2024; 14:13883. [PMID: 38880809 PMCID: PMC11180657 DOI: 10.1038/s41598-024-60656-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 04/25/2024] [Indexed: 06/18/2024] Open
Abstract
The purpose of this study was to investigate the prevalence and relevant factors of nocturia and its impact on sleep quality in university students in Mainland China. A large-scale survey was conducted on 14,000 university students from 3 universities in Henan province, China by using an anonymous questionnaire. The questionnaire collected the information from the past six months. The relationships between the prevalence of nocturia and its relevant factors were evaluated. A total of 13,874 questionnaires were collected and 13,104 qualified for statistical analysis. A total of 659 students suffered from clinically relevant nocturia (CRN) (4.56% in male and 5.34% in female). Both univariate analysis and the logistic stepwise regression model showed that the prevalence of nocturia was significantly related to female, history of enuresis, ease of waking up, urgency, frequency and RUTI (P < 0.05). The sleep quality and the university entrance score of CRN group was significantly lower than that of control group (P < 0.05). Nocturia was common in Chinese university students and showed a negative impact on sleep and academic performance. Gender of female, history of enuresis, ease of waking up, urgency, frequency and RUTI were relevant factors for CRN.
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Affiliation(s)
- Yakai Liu
- Department of Pediatric Surgery, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Zhenwei Zhang
- Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Huijie Hu
- School of Nursing, Sanquan College of Xinxiang Medical University, Xinxiang, China
| | - Xiangfei He
- Pediatric Urodynamic Center and Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Pengchao Xu
- Pediatric Urodynamic Center and Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qifeng Dou
- Department of Urology, the First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Cuiping Song
- Department of Pediatric Surgery, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Huiqing Zhang
- Department of Urology, the First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Israel Franco
- Yale New Haven Children's Hospital, New Haven, CT, USA
| | - Konstantinos Kamperis
- Department of Child and Adolescent Health, Aarhus University Hospital, Palle Juul-Jensens Blvd. 99, 8200, Aarhus, Denmark
| | - Søren Rittig
- Department of Child and Adolescent Health, Aarhus University Hospital, Palle Juul-Jensens Blvd. 99, 8200, Aarhus, Denmark
| | - Jianguo Wen
- Henan Joint International Pediatric Urodynamic Laboratory, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China.
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Torimoto K, Gotoh D, Nakai Y, Miyake M, Fujimoto K. Electroencephalography-based investigation of the effects of oral desmopressin on improving slow-wave sleep time in nocturnal polyuria patients (the DISTINCT study): A single-arm, open-label, single-assignment trial. Neurourol Urodyn 2024. [PMID: 38606623 DOI: 10.1002/nau.25476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/13/2024]
Abstract
AIMS To investigate changes in subjective and objective sleep quality after desmopressin administration in patients with nocturia due to nocturnal polyuria (NP) using electroencephalography (EEG) and the Pittsburgh sleep quality index (PSQI). METHODS Twenty male patients (≥65 years old) with NP participated in this study. The inclusion criteria were nocturnal frequency ≥ 2, NP index (NPi) ≥ 0.33, first uninterrupted sleep period (FUSP) ≤ 2.5 h, serum sodium concentration ≥ 135 mEq/L, and estimated glomerular filtration rate ≥ 50 mL/min/1.73 m2. Participants were given 50 μg of desmopressin to be taken orally once daily before bed. The primary endpoint was the change in the duration of slow-wave sleep (nonrapid eye movement sleep stages 3 and 4), as evaluated by EEG 28 days from the baseline. The visual analog scale (VAS) was used as an additional indicator of sleep quality. RESULTS Analysis of data from 15 participants (median age: 74.0 [70.5, 76.0] years) revealed that from before to after desmopressin administration, significant decreases occurred in the median nocturnal frequency (3.0 [2.0, 4.0] to 1.5 [1.0, 2.0]) and NPi (0.445 [0.380, 0.475] to 0.360 [0.250, 0.430]). Furthermore, FUSP was significantly prolonged from 120.0 (94.0, 150.0) min to 210.0 (203.8, 311.3) min. Although the VAS scores improved, slow-wave sleep duration and the PSQI global score showed no significant differences (68.50 [47.50, 75.50] and 48.00 [38.00, 66.50]; 5.0 [5.0, 10.0] and 7.0 [5.0, 9.0] min, respectively). CONCLUSION Oral administration of 50 μg desmopressin improved nocturnal frequency and FUSP in older individuals with NP but did not significantly enhance sleep quality. In older adults, decreased nighttime urinary frequency may enhance quality of life; however, its influence on objective sleep quality may be limited.
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Affiliation(s)
- Kazumasa Torimoto
- Department of Urology, Nara Medical University Hospital, Kashihara, Japan
| | - Daisuke Gotoh
- Department of Urology, Nara Medical University Hospital, Kashihara, Japan
| | - Yasushi Nakai
- Department of Urology, Nara Medical University Hospital, Kashihara, Japan
| | - Makito Miyake
- Department of Urology, Nara Medical University Hospital, Kashihara, Japan
| | - Kiyohide Fujimoto
- Department of Urology, Nara Medical University Hospital, Kashihara, Japan
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Babar M, Loloi J, Tang K, Singh S, Ines M, Patel RD, Iqbal N, Ciatto M. Rezum water vapor therapy for patients with mild, moderate, or severe lower urinary tract symptoms: A retrospective study in a multiethnic population. Prostate 2023; 83:713-721. [PMID: 36879380 DOI: 10.1002/pros.24508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/01/2022] [Accepted: 02/22/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND The Rezum System (Rezum) represents a novel, minimally invasive surgical therapy used to treat lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). We evaluated the safety and efficacy of Rezum in patients with mild, moderate, or severe LUTS. METHODS A single office, retrospective study was conducted on patients from a multiethnic population treated with Rezum between 2017 and 2019. Patients were categorized into three cohorts based on baseline International Prostate Symptom Score (IPSS) LUTS severity: mild LUTS (IPSS ≤ 7), moderate LUTS (IPSS 8-19), or severe LUTS (IPSS ≥ 20) cohorts. Outcome measures, including IPSS, quality of life (QoL), maximum urinary flow rate (Qmax), postvoid residual (PVR), BPH medication usage, and adverse events (AEs) were collected and analyzed at baseline, 1-, 3-, 6-, and/or 12-months postoperatively. RESULTS A total of 238 patients were included: 33 with mild LUTS, 109 with moderate LUTS, and 96 with severe LUTS. At 1-month follow-up, the moderate and severe LUTS cohorts saw significant improvements in IPSS (moderate LUTS: -3.0 [-6.0, 1.5], p < 0.001; severe LUTS: -10.0 [-16.0, -5.0], p < 0.001) and QoL (moderate LUTS: -1.0 [-3.0, 0.0], p < 0.001; severe LUTS: -1.0 [-3.0, 0.0], p < 0.001) and improvements remained durable up to 12-months (p < 0.001). The mild LUTS cohort saw significant worsening in IPSS by 2.0 (0.0, 12.0) at 1-month (p = 0.002) but returned to baseline at 3-months (p = 0.114). However, the mild LUTS cohort experienced significant improvements in QoL by -0.5 (-3.0, 0.0) at 3-months (p = 0.035) and nocturia by 0.0 (-1.0, 0.0) at 6-months (p = 0.002), both of which remained durable to 12-months (p < 0.05). Most AEs were transient and nonserious, with gross hematuria (66.5%) being most common. There were no significant differences in QoL point reduction, Qmax improvement, PVR reduction, and AE occurrence between the cohorts at 12-months (p > 0.05). At 12-months, 80.0%, 87.5%, and 66.0% of the patients in the mild, moderate, and severe LUTS cohorts discontinued their BPH medications, respectively. CONCLUSIONS Rezum provides rapid and durable relief in LUTS in patients with moderate or severe LUTS and can be offered to patients with mild LUTS who have bothersome nocturia and wish to discontinue their BPH medications.
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Affiliation(s)
- Mustufa Babar
- Albert Einstein College of Medicine, Bronx, New York, USA
- DSS Urology, Queens Village, New York, USA
| | - Justin Loloi
- Department of Urology, Montefiore Medical Center, Bronx, New York, USA
| | - Kevin Tang
- Albert Einstein College of Medicine, Bronx, New York, USA
| | | | | | - Rutul D Patel
- New York Institute of Technology College of Osteopathic Medicine, Old Westbury, New York, USA
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Athanasopoulos A. Nocturia due to nocturnal polyuria (NP). A common disorder. Arch Ital Urol Androl 2022; 94:366-368. [DOI: 10.4081/aiua.2022.3.366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 06/23/2022] [Indexed: 11/22/2022] Open
Abstract
To the Editor,
Nocturia is a significantly underestimated medical problem that affects seriously patients' quality of life, work engagement, productivity, and overall life conditions per se. Nocturia is a common condition, proven to be the most bothersome for patients with Lower Urinary Tract Symptoms (LUTS). People with two or more events of micturition per night have a significant increase in mortality rate and an increased risk of fall-related fractures if they visit the toilet two or more times per night [...].
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Matsuo T, Ito H, Mitsunari K, Ohba K, Miyata Y. Relationship between Urinary Calcium Excretion and Lower Urinary Tract Symptoms. Metabolites 2022; 12:metabo12030229. [PMID: 35323672 PMCID: PMC8953485 DOI: 10.3390/metabo12030229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 12/10/2022] Open
Abstract
To date, few detailed studies have been conducted on the convenient and useful markers for the prevalence of lower urinary tract symptoms (LUTS), including overactive bladder (OAB) and nocturia. A high level of calcium (Ca) excretion (hypercalciuria) is indicative of lifestyle-related diseases such as hypertension, which are associated with the onset of LUTS. Hence, in this study we attempted to clarify the relationship between urinary Ca excretion and OAB, nocturia, and nocturnal polyuria in adults. The present study showed that patients with hypercalciuria frequently experienced OAB, nocturia, and nocturnal polyuria. In addition, this study revealed that the severity of LUTS is significantly associated with urinary Ca excretion and that hypercalciuria is an important risk factor for OAB, nocturia, and nocturnal polyuria.
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Cheng W, Fan YH, Liou YJ, Hsu YT. The predictive factors of nocturia in young Asian adult males: an online survey. Sci Rep 2021; 11:16218. [PMID: 34376776 PMCID: PMC8355330 DOI: 10.1038/s41598-021-95836-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 07/30/2021] [Indexed: 12/28/2022] Open
Abstract
The present study investigated the association between severity of depressive mood and nocturia in young Asian adult men. Participants were 3127 adult male Facebook users aged 20–40 years who could read and write traditional Chinese. Participants completed online questionnaires on demographic characteristics, frequency of waking to urinate during the night (International Prostate Symptoms Score [IPSS]), and frequency of depressive symptoms (Taiwanese Depression Questionnaire [TDQ]). Those who awoke to pass urine during the main sleep period were considered to have nocturia. Student’s t test and Pearson’s chi square test were used to compare participants with and without nocturia. Univariate and multivariate logistic regression were used to evaluate predictive factors for nocturia. One thousand four hundred thirty (45.7%) participants had nocturia, and 21.9% were suspected to have depression. Age over 30 years, body mass index over 25 kg/m2, and higher IPSS score (except times of nocturnal voiding) were factors predictive of nocturia. Higher TDQ somatic subscores, rather than affective/cognitive subscores, were also predictive of nocturia. Associations were found between normal-high TDQ scores and nocturia. Young men with nocturia at risk of developing depression should be identified with a culturally relevant questionnaire. Early referral for psychiatric assessment and intervention may be warranted.
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Affiliation(s)
- Weiming Cheng
- Division of Urology, Department of Surgery, Taipei City Hospital, Zhongxiao Branch, Taipei, Taiwan.,Program in Molecular Medicine, College of Life Science, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Institute of Biopharmaceutical Science, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Urology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu-Hua Fan
- Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Urology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ying-Jay Liou
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Ting Hsu
- Division of Urology, Department of Surgery, Taipei City Hospital, Renai Branch, No. 10, Sec. 4, Renai Rd., Daan Dist., Taipei, 106243, Taiwan.
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Zhu B, Zou K, He J, Huang X, Zhu W, Ahmad Harb AK, Wang J, Luo A. Sleep Monitoring of Children With Nocturnal Enuresis: A Narrative Review. Front Pediatr 2021; 9:701251. [PMID: 34660477 PMCID: PMC8515414 DOI: 10.3389/fped.2021.701251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 08/26/2021] [Indexed: 01/12/2023] Open
Abstract
The purpose of this article is to provide a succinct summary of the sleep monitoring efforts that have been used in nocturnal enuresis (NE) and an overview of the knowledge that has accrued. This is not intended to be a comprehensive review, but rather is intended to highlight how polysomnography (PSG), a common sleep detection tool, has contributed to our understanding of NE, as arousal disorder is considered to be one of the important mechanisms. The authors have organized this report by analysis and display of different ingredients of PSG, starting with comparing the electroencephalogram (EEG) of controls and the enuretic children and then moving to evaluation of respiratory patterns of NE and comorbid disease obstructive sleep apnea (OSA). In addition, the authors' goal is to better understand the mechanism of NE by integrating various levels of sleep monitoring; those sleep-related clinical scale scores for NE are presented to date. Finally, we propose further research of NE to explore the microstructure alterations via PSG combined with EEG-fMRI or to use novel technology like portable device internet and deep learning strategy.
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Affiliation(s)
- Binbin Zhu
- Department of Anesthesia, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
| | - Kun Zou
- Department of Electrophysiology, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
| | - Jianhua He
- Department of Pediatric Surgery, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
| | - Xueqin Huang
- Department of Pediatric Surgery, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China.,Zhejiang Key Laboratory of Pathophysiology, Medical School of Ningbo University, Ningbo, China
| | - Weichao Zhu
- Department of Pediatric Surgery, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
| | - Ahmad Khaled Ahmad Harb
- Department of Anesthesia, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
| | - Jianhua Wang
- Department of Radiology, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
| | - Aiping Luo
- Department of Pediatric Surgery, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
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