440 LOW DOSE ORAL DESMOPRESSIN FOR THE TREATEMNT OF NOCTURNAL ENURESIS IN PATIENTS AFTER RADICAL CYSTECTOMY AND ORTHOTOPIC URINARY DIVERSION – A PROSPECTIVE CASE CONTROL STUDY

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality of Life1 Apr 2013440 LOW DOSE ORAL DESMOPRESSIN FOR THE TREATEMNT OF NOCTURNAL ENURESIS IN PATIENTS AFTER RADICAL CYSTECTOMY AND ORTHOTOPIC URINARY DIVERSION – A PROSPECTIVE CASE CONTROL STUDY Hanan Goldberg, Roy Mano, Jack Baniel, Daniel Keidar, Gabriel Gillon, and Ofer Yossepowitch Hanan GoldbergHanan Goldberg Petach Tiqva, Israel More articles by this author , Roy ManoRoy Mano Petach Tiqva, Israel More articles by this author , Jack BanielJack Baniel Petach Tiqva, Israel More articles by this author , Daniel KeidarDaniel Keidar Petach Tiqva, Israel More articles by this author , Gabriel GillonGabriel Gillon Petach Tiqva, Israel More articles by this author , and Ofer YossepowitchOfer Yossepowitch Petach Tiqva, Israel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1830AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Most patients undergoing radical cystectomy with orthotopic reconstruction report on intact daytime urinary continence. However, nocturia and nocturnal enuresis remain a major impediment to quality of life in this population. Oral Desmopressin is effective in the management of nocturia and nocturnal enuresis in men with benign prostate hypertrophy,cardiovascular morbidity and nocturnal polyuria. We endeavored to study the effect of Desmopressin in patients with orthotopic neobladders. METHODS All living patients who underwent radical cystectomy and orthotopic reconstruction in our department between 2004 and 2011 were asked to participate in this case-control study. Enrollment criteria included: eGFR > 50 ml/min/1.73 m2, normal baseline sodium serum levels, intact daytime urinary continence and ability to provide informed consent. Out of 55 patients, 34 were eligible and agreed to participate. The intervention included nighttime treatment with oral Desmopressin 0.1 mg for a total of 1 month. All patients completed an NNES-Q questionnaire (a validated quality of life tool to assess nocturia) upon entering the trial and conclusion. Sodium serum levels were monitored throughout the study period. RESULTS The study cohort included 32 men and 2 women at a median age of 64 (range 45-76). Thirty one patients completed 1 month of therapy, and 3 stopped the medication preceding study termination due to headaches (2) and anxiety (1). Nighttime awakenings decreased on average (SD) from 2.5 (1.4) to 1.5 (1.3) times per night (p=0.04). Thirteen patients (42%) reported on longer consecutive sleeping hours (an additional 1-2 hours) until the first episode of nocturnal enuresis and requested to continue the drug after trial closure. No alteration in sodium levels was observed in any of the study participants. CONCLUSIONS Nighttime treatment with low dose oral Desmopressin improved nocturia and nocturnal enuresis episodes in nearly half of the patients with orthotopic neobladders, with no associated adverse side effects. Reduction in sleep fragmentation was translated into better quality of life. Further investigation is warranted to test whether using higher dose of the medication would result in a better clinical response. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e180 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hanan Goldberg Petach Tiqva, Israel More articles by this author Roy Mano Petach Tiqva, Israel More articles by this author Jack Baniel Petach Tiqva, Israel More articles by this author Daniel Keidar Petach Tiqva, Israel More articles by this author Gabriel Gillon Petach Tiqva, Israel More articles by this author Ofer Yossepowitch Petach Tiqva, Israel More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...