Sujets)
Sujet âgé , Humains , Mâle , Adulte d'âge moyen , Antagonistes muscariniques/usage thérapeutique , Nycturie/traitement médicamenteux , Quinuclidines/usage thérapeutique , Troubles de la veille et du sommeil/traitement médicamenteux , Tétrahydroisoquinoléines/usage thérapeutique , Vessie hyperactive/traitement médicamenteux , Nycturie/complications , Enquêtes et questionnaires , Troubles de la veille et du sommeil/complications , Vessie hyperactive/complications , Miction impérieuse incontrôlable/complications , Miction impérieuse incontrôlable/traitement médicamenteuxRésumé
To investigate the efficacy and safety of desmopressin in patients with mixed nocturia, Patients aged > or =18 yr with mixed nocturia (> or =2 voids/night and a nocturnal polyuria index [NPi] >33% and a nocturnal bladder capacity index [NBCi] >1) were recruited. The optimum dose of oral desmopressin was determined during a 3-week dose-titration period and the determined dose was maintained for 4 weeks. The efficacy was assessed by the frequency-volume charts and the sleep questionnaire. The primary endpoint was the proportion of patients with a 50% or greater reduction in the number of nocturnal voids (NV) compared with baseline. Among 103 patients enrolled, 94 (79 men and 15 women) were included in the analysis. The proportion of patients with a 50% or greater reduction in NV was 68 (72%). The mean number of NV decreased significantly (3.20 to 1.34) and the mean nocturnal urine volume, nocturia index, NPi, and NBCi decreased significantly. The mean duration of sleep until the first NV was prolonged from 118.4+/-44.1 to 220.3+/-90.7 min (P<0.001). The overall impression of patients about their quality of sleep improved. Adverse events occurred in 6 patients, including one asymptomatic hyponatremia. Desmopressin is an effective and well-tolerated treatment for mixed nocturia.