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Desmopressin for treating nocturia in men.

Julia Han1, Jae Hung Jung, Caitlin J Bakker

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Area of Science:

  • Urology
  • Pharmacology
  • Evidence-based Medicine

Background:

  • Nocturia, characterized by nighttime awakenings to void, significantly impacts quality of life.
  • Desmopressin is a widely prescribed medication for nocturia management.

Purpose of the Study:

  • To evaluate the efficacy and safety of desmopressin versus other interventions for treating nocturia in men.
  • To synthesize evidence from randomized controlled trials on desmopressin's impact on nocturnal voiding frequency and adverse events.

Main Methods:

  • Comprehensive literature search across multiple databases with no language or publication status restrictions.
  • Inclusion of randomized or quasi-randomized trials focusing on men with nocturia; exclusion of enuresis and specific disorders.
  • Data abstraction and statistical analysis using a random-effects model following Cochrane guidelines.

Main Results:

  • Desmopressin showed a potential reduction in nocturnal voids compared to placebo at intermediate-term follow-up (3-12 months) with low-quality evidence.
  • Short-term use of desmopressin demonstrated similar effects on voiding frequency and quality of life compared to alpha-blockers.
  • No significant added benefit was observed for desmopressin combined with alpha-blockers or anticholinergics.

Conclusions:

  • Desmopressin may effectively reduce nocturnal voids in men over 3-12 months without increasing major adverse events compared to placebo.
  • Evidence comparing desmopressin to behavior modification is lacking.
  • Desmopressin offers comparable short-term efficacy to alpha-blockers for nocturia, with limited added benefit in combination therapies.