In a nutshell
This study investigated the effects of combining behavioral therapy and anti-muscarinic medications with alpha-blockers to treat nocturia in men. The study concluded that the addition of behavioral therapy resulted in a greater improvement in symptoms compared to anti-muscarinic drugs.
Some background
Treating nocturia can be difficult and often involves medication aimed at treating related conditions. Since enlarged prostate is a common cause of urinary symptoms in men, alpha-blockers are a common first-choice therapy. These medications block alpha-adrenoreceptors, causing the prostate to relax thereby reducing the urge to urinate.
However, such medications do not always treat nocturia effectively. Addition of other prostate and bladder relaxing medications, such as anti-muscarinic drugs may be helpful. Behavioral treatment may also improve nocturia by strengthening pelvic floor muscles and using strategies to resist the urge to urinate.
Methods & findings
This study investigated the effects of combining either behavioral therapy or anti-muscarinic drugs with standard alpha-blocker treatment for nocturia.
The study included 127 men with nocturia on standard alpha-blocker therapy (tamsulosin or another drug). Patients were randomly assigned to undergo behavioral treatment or receive anti-muscarinic drug therapy. Behavioral treatment included exercised to strengthen pelvic floor muscles and practicing strategies to resist the urge to urinate. The number of nighttime voids (urinations) were recorded.
Patients in both groups reported a reduction in the number of nighttime voids; however, behavioral therapy patients reported the greatest improvement. Overall, behavioral therapy reduced nightly voids by an average of 0.97 voids, compared to a reduction of 0.56 voids with anti-muscarinic therapy.
Behavioral therapy was also more effective among men who woke 2 or more times per night to urinate. Behavioral therapy reduced nocturia episodes by an average of 1.21 voids, compared to a decrease of 0.64 voids with anti-muscarinic therapy.
The bottom line
The authors concluded that the addition of behavioral therapy resulted in a greater improvement in nocturia symptoms compared to anti-muscarinic drugs.
What’s next?
Consult with your physician regarding strategies to treat nocturia
Published By :
BJU international
Date :
Jul 01, 2013
