Login to Access Video or Poster Abstract: MP09-09
Sources of Funding: None

Introduction

Nocturia is defined as two or more voids per night. We evaluated the effects of desmopressin compared to other interventions in the treatment of nocturia in men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH).

Methods

We conducted a Cochrane review based on an a priori, protocol that included published and unpublished randomized controlled trials (RCTs) in any language. We excluded trials of children or adults with primary or secondary enuresis or underlying medical disorders. Primary outcomes were the number of nocturnal voids, quality of life (QoL), and major adverse events (AEs); secondary outcomes were duration of first sleep episode, time to first void, minor AEs, and treatment withdrawal due to AEs. We performed meta-analysis using RevMan 5.3 and rated the quality of evidence using GRADE.

Results

Of 271 studies identified through our search, we included 10 studies. Desmopressin was associated with a small decrease in the number of nocturnal voids (mean difference [MD] -1.1, 95% confidence interval [CI] -1.4 to -0.9; low quality evidence) and similar rates of major AEs (risk ratio [RR] 0.9, 95% CI 0.1 to 9.0; very low quality of evidence). We found no evidence for QoL. Compared to alpha-blockers, there was a similar reduction in the number of nocturnal voids (MD -0.2, 95% CI 01.2 to 0.7; very low quality evidence) and similar quality of life (MD -0.2, 95% CI -0.4 to 0.1; moderate quality of evidence). Rates of major AEs were similar (RR not estimable; low quality evidence).

Conclusions

Current best evidence from RCTs in men with the chief complaint of nocturia suggests that desmopressin may result in a small reduction in the number of nocturnal voids with similar major AE rates compared to placebo. We are uncertain whether it reduces the number of nocturnal voids similarly to alpha-blockers. Additional well-designed studies using active controls are needed.

Funding

None