title: Low-dose oral desmopressin for treatment of nocturia and nocturnal enuresis in patients after radical cystectomy and orthotopic urinary diversion.
abstract: OBJECTIVE
  To assess the effect of oral desmopressin on nocturia and nocturnal enuresis in patients after orthotopic neobladder reconstruction.
  
  
  METHODS
  Of 55 patients who underwent radical cystectomy and orthotopic neobladder reconstruction at our medical centre in the period 2004-2011, 34 patients were deemed eligible for the present study. Inclusion criteria were estimated glomerular filtration rate >50 mL/min/1.73 m(2) , normal baseline sodium serum level, intact daytime urinary continence, and any degree of nocturia or nocturnal enuresis. Patients were treated daily with oral desmopressin 0.1 mg at bedtime for 30 days and completed the Nocturia, Nocturnal Enuresis and Sleep Interruption Questionnaire at trial enrollment and closure. Sodium serum levels were monitored throughout.
  
  
  RESULTS
  Three patients withdrew from the trial because of headaches or anxiety. The mean (sd) number of nocturnal voids decreased from 2.5 (1.4)/night at baseline to 1.5 (1.3)/night at trial closure (P = 0.015). The number of patients with one or no episodes of nocturnal enuresis per week increased from six to 12 (19 to 39%; P = 0.065). Thirteen patients (42%) reported an increase of a minimum 1-2 h of sleep until the first nocturnal void; all of them asked to continue the drug. No significant adverse events or changes in sodium level were observed.
  
  
  CONCLUSIONS
  Bedtime treatment with low-dose oral desmopressin appears to decrease episodes of nocturia and nocturnal enuresis effectively and safely in ∼50% of the patients with neobladder, allowing longer undisrupted sleep time and improved quality of life. Further investigation is warranted to determine if higher doses would result in a more meaningful clinical response.
authors: Institute of Urology, Rabin Medical Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Hanan
authors: H
authors: Goldberg
authors: Jack
authors: J
authors: Baniel
authors: Roy
authors: R
authors: Mano
authors: Gabriel
authors: G
authors: Gillon
authors: Daniel
authors: D
authors: Kedar
authors: Ofer
authors: O
authors: Yossepowitch
mesh_terms: D000368:Aged; D050034:Antidiuretic Agents / Q000008:administration & dosage*; D015653:Cystectomy / Q000009:adverse effects*; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053158:Nocturia / Q000188:drug therapy* / Q000209:etiology; D053206:Nocturnal Enuresis / Q000188:drug therapy* / Q000209:etiology; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014547:Urinary Diversion / Q000009:adverse effects*
chemical_list: D050034:Antidiuretic Agents; D003894:Deamino Arginine Vasopressin
keywords: NNES-Q; desmopressin; nocturia; nocturnal enuresis