Oral Desmopressin as an Add-on Therapy for Men with Benign Prostate Hyperplasia they Suffering from Persistent Nocturia

Background: men with benign prostate hyperplasia suffer from urinary tract infection especially in lower part of the tract and common manifestation of this infection is nacturia. Treatment of nocturia depends mainly on α-blockers; however, these drugs have limited success in relieving this symptom. Aims: This study aims to assess the efficacy of desmopressin (0.2mg) as an add-on therapy with α-blockers in relieving refractory nocturia for men with BPH. Patients and Methods: Inclusion criteria for this prospective, nonrandomized, open-label trial included men ≥60 years old with LUTS due to BPH; a total IPSS of ≥14 points; and persistent nocturia with ≥2 voids/night despite using α-blockers for at least 10 weeks prior to inclusion. Patients with diabetes mellitus, known neurogenic bladder dysfunction, uncontrolled hypertension, congestive heart failure, and those using diuretics were excluded from the study. Fifty one patients were included and categorized into two groups; those who continued on α-blocker treatment (n=22), and those for whom oral desmopressin (0.2 mg) was used as an add-on therapy (n=29). After four weeks of treatment, the International Prostate Symptom Score (IPSS), storage and voiding subs-scores, nocturia episodes, maximal flow rate (Q_max) and bother score were measured and compared with their respective baseline values. Results: there were no difference significantly between the two groups in all measured demographic and clinical parameters (all p-values >0.05). After four weeks of treatment, the total IPSS, storage sub-score, nocturia episodes, and bother score were all significantly better in the group were desmopressin add-on ( P-values ≤0.05). No significant differences were observed in the voiding sub-score and Q_max value between the two groups (both p-value >0.05). Conclusion: adding desmopressin to α-blockers is active therapy for men with BPH and suffering nocturia and no initial response to α-blockers