Nocturia and sleep quality after transurethral resection of the prostate

Abstract

Abbreviations & AcronymsObjectives: To evaluate the clinical efficacy of transurethral resection of the prostate on nocturia and sleep disorders in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction. Methods: A prospective multicenter study including lower urinary tract symptoms suggestive of benign prostatic obstruction patients with nocturia (twice or more) undergoing transurethral resection of the prostate was carried out. All patients were assessed using the International Prostate Symptom Score and the Pittsburgh Sleep Quality Index at baseline, and 6 months after transurethral resection of the prostate. Results: Overall, 49 patients were included in the study. A total of 20 of them (41%) had a sleep disorder defined as a score of 5.5 or more on the Pittsburgh Sleep Quality Index global score. The nocturia score significantly correlated with component 4 of the Pittsburgh Sleep Quality Index (habitual sleep efficiency). Nocturia significantly decreased after transurethral resection of the prostate from 3.0 ± 1.2 to 1.9 ± 0.8, whereas the global Pittsburgh Sleep Quality Index score did not. In 20 patients with a sleep disorder before transurethral resection of the prostate, subjective sleep quality (component 1) and habitual sleep efficiency (component 4) significantly decreased after transurethral resection of the prostate, but this was not the case for the global Pittsburgh Sleep Quality Index score. In 16 patients with a persistent sleep disorder after transurethral resection of the prostate, International Prostate Symptom Score, voiding and storage symptoms score were higher than those of patients without a sleep disorder, although the nocturia score improved equivalently in both groups. Conclusions: Transurethral resection of the prostate diminishes nocturnal urinary frequency and partly improves sleep quality in patients with nocturia and lower urinary tract symptoms suggestive of benign prostatic obstruction. A persistent sleep disorder after transurethral resection of the prostate is associated with persistent voiding and storage symptoms.

Metabolic syndrome and smoking are associated with persistence of nocturia after transurethral resection of the prostate

“…In addition, nocturia is strongly associated with benign prostatic hyperplasia (BPH) and nocturnal polyuria . Wada et al, in a small study, investigated whether TURP could improve nocturia and sleep disorders in patients with LUTS/BPO undergoing TURP. According to their results, nocturia score showed the least improvement among the seven subscores of IPSS, however in this study, nocturia severity was not reported.…”

The evaluation of nocturia in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia and the analysis of the curative effect after medical or placebo therapy for nocturia: a randomized placebo-controlled study

“…Based on the literature [5], we estimated that 74 patients will need to be recruited in order to detect a clinically significant difference of 25% between the 2 groups (with a power of 80%). Based on past clinical trial experience, we estimated that 20% of randomized participants will be lost in follow up, therefore 88 patients will need to be recruited, and 170 participants who will complete the item in our study.…”

Nykturie beim Benignen Prostatasyndrom

“…So könnte die Deobstruktion der Prostata als ultima ratio auch zur Behandlung der Nykturie bei persistierenden LUTS angesehen werden. Obwohl die Nykturiefrequenz mit einer TURP signifikant gesenkt werden kann, in einer Untersuchung mit 49 Patienten von durchschnittlich 3,0 ± 1,2 auf 1,9 ± 0,8 Mal pro Nacht [29] und in einer anderen Untersuchung mit 56 Patienten von 3,4 ± 1,2 auf 2,6 ± 0,99 pro Nacht [30], ist die Nykturie das am häufigsten persistierende Einzelsymptom nach TURP [22]. In einer dänischen Untersuchung mit 62 Patienten lag bei 50 % der mit TURP behandelten Männer auch noch 5 Jahre nach der Operation eine Nykturie vor [31].…”

“…In einer dänischen Untersuchung mit 62 Patienten lag bei 50 % der mit TURP behandelten Männer auch noch 5 Jahre nach der Operation eine Nykturie vor [31]. Die TURP kann aber bei der Mehrheit der Patienten die Schlaf-und Lebensqualität verbessern und die ungestörte Schlafzeit signifikant, wenn auch nur um weniger als 1 Stunde verlängern [29,30]. Die persistierende Schlafstörung nach TURP war in einer Untersuchung mit der Persistenz von Blasenspeicher-und Blasenentleerungssymptomen assoziiert [29].…”