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전립선비대증의 일차약물치료 후 지속되는 야간뇨를 호소하는 환자들의 주관적 불편감에 따른 특성 분석과 이들 중 야간다뇨가 입증된 환자들에서 Desmopressin 단독요법에 대한 치료결과

Study on Persistent Nocturia after Treatment of Benign Prostatic Hyperplasia and Effectiveness of Desmopressin in Persistent Nocturia with Nocturnal Polyuria

대한비뇨기과학회지 2008년 49권 10호 p.899 ~ 905
정재영 ( Jong Jae-Young ) - 분당제생병원 비뇨기과

손정환 ( Son Jeong-Hwan ) - 분당제생병원 비뇨기과

Abstract


Purpose: We evaluated the differences in treatment outcomes between patients who complained of nocturia and patients who did not complain of nocturia after treatment with medication for benign prostatic hyperplasia(BPH) for >6 months. We also investigated the effectiveness of desmopressin on persistent nocturia after BPH medication.

Materials and Methods: One hundred forty-nine patients with 3 or more episodes of nocturia, despite treatment with BPH medications, were enrolled. Patients were divided into two groups according to complaints or absence of complaints of persistent nocturia. We compared differences of the International Prostate Symptom Score(IPSS), quality of life(QoL), and nocturia between the two groups. Patients who complained of persistent nocturia were subdivided into the following three groups after administration of desmopressin(0.2mg/day) with cessation of BPH medication: group I, decreased nocturia(>2 episodes per night) with desmopressin only; group II, decreased nocturia with desmopressin, but the BPH symptoms are aggravated, and the previous medication was added; group III, no change of nocturia despite desmopressin. We analyzed the differences in each group.

Results: Patients who complained of nocturia after BPH medication had a greater decrease in IPSS than those who did not complain of nocturia (p=0.047). Twenty percent(n=9) of the patients had decreased nocturia and were satisfied with desmopressin treatment, Twenty-four of the patients (53.3%) had decreased nocturia, but needed a combination with the previous BPH medication, while desmopressin was not effective in 26.7% (n=12) of the patients. The improvement of BPH after primary treatment was more evident in patients who experienced efficacy with desmopressin.

Conclusions: Desmopressin can be an effective treatment for persistent nocturia in patients with nocturnal polyuria components. The more improvement in BPH after primary treatment, the better the effects of desmopressin can be expected. We cannot overemphasize the importance of a voiding diary and analysis of nocturia.

키워드

Benign prostatic hyperplasia;Nocturia;Desmopressin
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