Correction of nocturia in patients with benign prostatic hyperplasia. Mini-review and analysis of clinical observations

Aim. To outline the importance of nocturia in benign prostatic hyperplasia (BPH) and justify the feasibility and clinical need for antidiuretic therapy in these patients.

Materials and methods. This article is a literature review. PubMed, Embase, and eLibrary databases were used for the search. Relevant publications were included in the literature review. The pilot study included 20 male patients aged 58–75 years with a confirmed diagnosis of BPH. Patients were divided into two groups: standard therapy (Tamsulosin Canon) and combined therapy (Tamsulosin Canon + Nourem). Diurnal diuresis was assessed based on the results of the Zimnitsky test and the nocturnal bladder volume index before and after treatment.

Results. During standard therapy, patients had a decrease in the severity of obstructive and irritative symptoms and an improvement in the QoL index (p<0.05). However, there was no significant improvement in nocturia. In the combined therapy group, the severity of symptoms significantly decreased by 53.3%, and the QoL index improved by 62.5%. On average, the sleep duration increased by 1.5 hours with almost unchanged rates of daily diuresis.

Conclusion. The study showed that in 65% of patients, nocturia was caused not by anatomical and functional changes in the prostate and lower urinary tract but by nocturnal polyuria. Its management has a major role in nocturia treatment. The only pathogenesis-based treatment is the antidiuretic therapy (desmopressin) added to the α₁-blocker.