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

Abstract

BackgroundTo study nocturia in patients with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) after medical or placebo treatment.MethodsPatients with LUTS suggestive of BPH from several community clinics were included. Patients completed the International Prostate Symptom Score (I-PSS) questionnaire and a 3-day voiding diary. Urinalysis, prostate-specific antigen (PSA) measurement, and prostate ultrasonography were performed. Nocturnal polyuria (NP) was defined as a nocturnal urine fraction exceeding one third of the daily urine output in elderly men. A total of 148 outpatients were randomized to drug treatment (tamsulosin) or placebo treatment. After 8 weeks of treatment, they were re-evaluated using a 3-day voiding diary, PSA measurement, prostate volume (PV), I-PSS, etc.ResultsThe average I-PSS score was 20.3, storage symptom score was 11.7, voiding symptom score was 8.6, quality of life (QoL) score was 3.7, PV was 40.4 ± 19.4 ml, and nocturnal urine volume (NUV) was 845.7 ± 339.0 ml. The mean frequency of nocturia was 2.3 ± 1.1 per day, and 94% of the patients had a nocturia frequency of more than two times per day. Of these patients, 76.5% had NP. A significant correlation was found between NUV and the amount of water intake at night and 4 h before sleep (r = 0.419,P = 0.002; r = 0.302,P = 0.031). Eighty patients were randomized to drug treatment (tamsulosin) and 68 patients were randomized to placebo treatment. The I-PSS score was 16.8 ± 4.9 to 19.3 ± 5.0 (p = 0.002), the storage symptom score was 10.3 ± 3.4 to 10.7 ± 3.4 (p = 0.007), and the voiding symptom score was 7.5 ± 2.4 to 8.6 ± 2.3 (p = 0.003). The frequency of daytime urination was 7.5 ± 2.6 to 8.1 ± 2.6 (p = 0.002), maximum urine volume (ml) was 372.8 ± 103.3 to 302.8 ± 119.3 (p = 0.007), and morning urine volume (ml) was 280.5 ± 111.7 to 259.5 ± 100.7 (p = 0.003). However, the frequency of nocturia score was 2.8 ± 0.7 to 3.0 ± 0.6 (p = 0.306) and the nocturnal urine volume (ml) was 800.7 ± 323.0 to 845.7 ± 303.5 (p = 0.056), which did not change significantly. There were significant differences between the NP and non-NP groups in the duration of LUTS, first voided urine volume, daytime urination frequency, and the amount of water intake at night and 4 h before sleep.ConclusionsAmong the symptoms of LUTS, the improvement rates for nocturia were the lowest after medical treatment for BPH. The α-blockers did not improve nocturia, which was a common symptom accompanying LUTS suggestive of BPH. Our results showed that the prevalence of NP was 76.5% and that NP was significantly related to the amount of water intake during the evening and before sleep.Trial registrationISRCTN registry, Trial registration number (TRN): ISRCTN85509614, Date of registration: 30/10/2018. This trial was registered retrospectively.

Determining the quality of life and the sleep quality in patients with benign prostate hyperplasia

“…15 Again in the literature, it is stated that there is a positive relationship between the sleep quality and physical and psychological domain and this situation is reported to be independent from age. 15 Again in the literature, it is stated that there is a positive relationship between the sleep quality and physical and psychological domain and this situation is reported to be independent from age.…”

“…In a randomized controlled study with patients with BPH carried out to identify the frequency of nocturia, the frequency of lower urinary system symptoms, sleep quality and quality of life, a positive correlation was reported between sleep quality and quality of life. 15 Again in the literature, it is stated that there is a positive relationship between the sleep quality and physical and psychological domain and this situation is reported to be independent from age. 16 It was determined that there was a significant positive correlation between sleep quality of the patients and the mean scores of quality of life.…”

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“…Diferentes estudios muestran que existe una fuerte asociación entre los STUI y la disfunción eréctil (DE) (27) . En el estudio Multinational Survey of the Aging Male (MSAM 7), que utiliza el Índice Internacional de Función Eréctil (IIFE), se comprobó una relación directa de la DE con la gravedad de los STUI, independientemente de la edad (28) .…”

“…Silodosina ha demostrado ser efectiva y segura para mejorar la nocturia, reduciendo significativamente los episodios (27) . Esta mejoría específica sobre la nocturia no se ha demostrado hasta el momento con la tamsulosina (28) . El naftopidil parece tener efectos similares en las puntuaciones de los STUI y la Cdv en comparación con la tamsulosina y la silodosina (29) .…”

Urination behaviours of senior citizens in five Chinese cities: Results of a cross‐sectional survey

“…elderly men have prostatic hyperplasia and hypertrophy, in which pressure is exerted on the bladder outlet and the internal orifice of the urethra, which can cause increases ins urination resistance, difficulty holding back urine, obstruction to urine flow, and urination frequency as well as excessive nocturia, laborious urination and other related symptoms. [6][7][8][9] Elderly women are prone to frequent urination and nocturia 10,11 because when bladder and urethra functions are uncoordinated, control over the urethra weakens and the fibrous tissue of the bladder neck increases, leading to obstruction of the bladder neck. 12,13 Studying the urination behaviours of elderly adults can provide helpful information for identifying potential urinary system diseases that develop over time.…”