In a nutshell
This study investigated treatment for nocturia in women. They found that desmopressin (Noctiva) and antimuscarinic (AM) drugs are effective.
Some background
Nocturia is a condition where there is an increased need to urinate at night. Nocturnal incontinence (NI) is the term used to describe bedwetting. Nocturia and NI are more common in older age. It affects both women and men. Nocturia and NI are associated with reduced quality of life (QoL). Treating these conditions is important.
There are no clear guidelines on the treatment of nocturia or NI. The European Association for Urology (EAU) does not include these in their guideline. It is unclear what is the optimal treatment for nocturia/NI in women.
Methods & findings
This study included 11 clinical reports of nocturia/NI in women. Studies were analyzed by comparing data from patients treated for nocturia/NI. The authors reviewed the evidence for each treatment option. These included pharmacological (drug) and behavioral treatment (BT).
Desmopressin (DP) was investigated in 3 studies. DP was associated with improved nocturia/NI in women. Compared to placebo, women who took DP had 0.75 fewer episodes of nocturia/NI. Women can be treated with lower doses of DP than men.
Antimuscarinic drugs (AMDs) were investigated in 4 trials. AMDs improved nocturia symptoms. This includes the number of urinations (voids). Of the AMDs, oxybutynin (Ditropan) was associated with 0.3 fewer episodes of nocturia/NI compared to placebo. Tolterodine (Detrol) with or without BT also improved nocturia.
Oestrogen was investigated in one study. There was no indication that it improved nocturia. BT was analyzed in 4 studies. BT included various methods of bladder training. Some types of BT improved nocturia. Comparing the different types is difficult. However BT may be beneficial.
The bottom line
The authors concluded that DP and AMDs are effective for women who experience nocturia and/or NI.
The fine print
There were important differences between the studies analyzed. Most studies investigated nocturia and not NI. More studies are needed.
What’s next?
If you have any concerns regarding nocturia please consult with your doctor.
Published By :
European urology focus
Date :
Feb 12, 2020
