Do you get up to urinate a lot at night?

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Nelson Vergel

Founder, ExcelMale.com
Nocturia (getting up to pee frequently at night) can be caused by benign prostatic inflammation (BPH) or excessive urine production at night time. This study reviewed the pharmaceutical options to manage this issue that can impair stamina and quality of life (including erectile function) in men.
Current pharmacotherapy of nocturia - PubMed

Expert Opin Pharmacother. 2013 May;14(7):885-94. doi: 10.1517/14656566.2013.783020. Epub 2013 Apr 5.

Current pharmacotherapy of nocturia.Smith A, Wein A.



Abstract

INTRODUCTION: Nocturia is a bothersome urologic symptom and is defined as awakening from sleep once or more times to void. The condition is highly prevalent in men and women and increases in prevalence with age. Impact on quality of life is substantial as is the associated morbidity and mortality.

AREAS COVERED:A PubMed literature search was undertaken to identify evidence for the currently available and utilized pharmacotherapy options for the treatment of nocturia. Available pharmacologic treatments include desmopressin, alpha blockers, antimuscarinics, and other less commonly utilized therapies. Desmopressin is generally found to have high-level evidence to support its use for the indication of nocturnal polyuria, a form of nocturia caused by excessive nighttime urine production. Alpha-blockers and antimuscarinics are generally recommended in the setting of benign prostatic hypertrophy in men and overactive bladder in both men and women.

EXPERT OPINION: Clinical trials addressing nocturia often report statistically significant results that do not translate to clinically significant reductions in nighttime voids. As a result, the clinical utility of these agents has been called into question. Further drug development and clinical trials specifically focused on nocturia are needed. Furthermore, improved patient-focused assessment tools to measure the impact on symptom reduction, improvement in sleep quality, and improvement in quality of life are important in understanding what matters most to patients and what outcomes translate to patient satisfaction with care.
 
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In addition to meeting the study's primary endpoints, Owens-Grillo and colleagues reported that participants receiving vibegron were more likely to experience both ≥50% and ≥75% reductions in urgency episodes at all time points compared with placebo -- these ≥50% and ≥75% thresholds having been associated with clinical meaningfulness, based on the prior literature.

Vibegron was also associated with a significant reduction in mean daily nocturia episodes (-0.88 vs -0.66, P=0.002), UUI episodes (-2.19 vs -1.39, P=0.003), International Prostate Symptom Score-storage scores (-3.0 vs -2.1, P<0.0001), and volume voided per micturition (25.63 mL vs 10.56 mL, P<0.0001).

The demonstrated reduction in nocturnal frequency was highlighted as "lending credence to the importance of storage symptoms as a contributor to nocturnal urinary events," according to Roger Dmochowski, MD, MMHC, of Vanderbilt University Medical Center in Nashville, Tennessee.

 
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