title: Changes in nocturia from medical treatment of benign prostatic hyperplasia: secondary analysis of the Department of Veterans Affairs Cooperative Study Trial.
abstract: OBJECTIVE
  We evaluate the efficacy of medical therapy on nocturia in men with benign prostatic hyperplasia (BPH).
  
  
  METHODS
  We performed a secondary analysis of data from the VA Cooperative Study Program Trial in which 1,229 men with BPH 45 to 80 years old were randomly assigned to receive terazosin, finasteride, combination or placebo.
  
  
  RESULTS
  The 1,078 men who completed 12 months of the trial are included in this study. Of those men 1,040 (96.5%) had at least 1 episode of nocturia at baseline and 38 (3.5%) had less than 1 episode (baseline nocturia is an average of 2 measures). Of those 1,040 men 788 (75.8%) had 2 or more nocturia episodes. Overall, nocturia decreased from a baseline mean of 2.5 to 1.8, 2.1, 2.0 and 2.1 episodes in the terazosin, finasteride, combination and placebo groups, respectively. Of men with 2 or more episodes of nocturia 50% reduction in nocturia was seen in 39%, 25%, 32% and 22% in the terazosin, finasteride, combination and placebo groups, respectively. Changes in nocturia were correlated with changes in reported bother from nocturia (Pearson correlation 0.48), BPH impact index (0.32) and overall satisfaction with urinary symptoms (0.33).
  
  
  CONCLUSIONS
  Terazosin and combination therapy reduced nocturia in men with BPH, yet the net advantage of terazosin over placebo was a net reduction of 0.3 nocturia episode. For a person to reach a 50% or greater reduction in nocturia, the advantage of terazosin over placebo was 17 percentage points. Changes in nocturia had a moderate impact on symptom specific quality of life measures.
authors.affiliation: Birmingham/Atlanta GRECC, Atlanta VA Medical Center, 16780 Clairmont Road, Decatur, GA 30033, USA.
authors.forename: Theodore M
authors.initials: TM
authors.lastname: Johnson
authors.forename: Karen
authors.initials: K
authors.lastname: Jones
authors.forename: William O
authors.initials: WO
authors.lastname: Williford
authors.forename: Michael H
authors.initials: MH
authors.lastname: Kutner
authors.forename: Muta M
authors.initials: MM
authors.lastname: Issa
authors.forename: Herbert
authors.initials: H
authors.lastname: Lepor
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000368:Aged; D004359:Drug Therapy, Combination; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D018120:Finasteride / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011224:Prazosin / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D011470:Prostatic Hyperplasia / Q000150:complications / Q000188:drug therapy*; D011788:Quality of Life; D014555:Urination Disorders / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000317:Adrenergic alpha-Antagonists; D004791:Enzyme Inhibitors; D018120:Finasteride; C041226:Terazosin; D011224:Prazosin