You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Non-Neurogenic Voiding Dysfunction1 Apr 20111964 THE SAFETY OF DESMOPRESSION IN ELDERLY MEN WITH NOCTURNAL POLYURIA Ji-Yeon Han, Doejung Kim, Dae Heon Choi, and Myung-Soo Choo Ji-Yeon HanJi-Yeon Han SEOUL, Korea, Republic of More articles by this author , Doejung KimDoejung Kim SEOUL, Korea, Republic of More articles by this author , Dae Heon ChoiDae Heon Choi SEOUL, Korea, Republic of More articles by this author , and Myung-Soo ChooMyung-Soo Choo SEOUL, Korea, Republic of More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2168AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Nocturia is a common lower urinary tract symptom in the elderly and deteriorates the quality of sleep and health. The most common cause of nocturia is nocturnal polyuria. So desmopressin, synthetic analogue of AVP (antidiuretic hormone arginine vasopressin) can reduce night time urine production and is indicated widely for treatment of nocturia. A particular concern for its use is the risk of hyponatremia, especially in elderly men. So we evaluated the safety of desmopressin in elderly men with nocturnal polyuria through long-term follow-up. METHODS We retrospectively analyzed nocturia patients who were more than 65 years and had been treated with desmopressin at least 6 months for nocturnal polyuria (Nocturia Index scores of ≥1). When prescribing drugs, we explained the mechanism of desmopressin and educated to patients the followings; (1) Take pill just before sleep with a sip of water (2) Void before sleep (3) Restriction of fluid for two hours before sleep and during sleep (4) If patients feel dry mouth, recommend them to wash the mouth 5. If hyponatremic symptoms such as weight gain, edema, seizure, dizziness, fatigue etc., occur, we recommend them to discontinue desmopressin and visit hospital. In all patients the serum Na level before medication was within normal range (135-145mEq/L) and was examined medication after 3-7 days, every 3-6 months and at dosage changes. Safety was evaluated by hyponatremia (serum Na level <130mEq/L) and hyponatremic symptoms. RESULTS We enrolled 68 patients (male 55/female 13) and the mean (range) age of the patients was 72.6 (66-85) years. Patients with associated disease were also included (cerebrovascular disease 23.5%, ischemic heart disease 13.2%, neurologic disease 7.3%, chronic renal failure (Cr level 1.8-2.5ng/dL) 1.4%). The mean medication period was 27.9 (6.3-78.7) months. The mean serum Na level before medication was 141.0±1.9 mEq/L. The estimate of hyponatremia incidence was 4.4% (3/68). There were no predictive factors for hyponatremia in patients′ characteristics (age, associated disease, other medication, dose of medication and medication period). The mean frequency of nocturia was 6.1 before desmopressin and most (91%) patients had an improvement in nocturia with desmopressin. There was 2.1 (66.1%) reduction in frequency of nocturia and 374.2±261.3 ml reduction in nocturnal urine volume after using desmopressin. The mean decrease of serum Na level was 1.1±3.2mEq/L. CONCLUSIONS Desmopressin is safe and effective for nocturnal polyuria in elderly men-more than 65 years old-if properly educated and explained about the caution. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e786 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ji-Yeon Han SEOUL, Korea, Republic of More articles by this author Doejung Kim SEOUL, Korea, Republic of More articles by this author Dae Heon Choi SEOUL, Korea, Republic of More articles by this author Myung-Soo Choo SEOUL, Korea, Republic of More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...