Efficacy of adding behavioural treatment or antimuscarinic drug therapy to α‐blocker therapy in men with nocturia. (28th February 2013)

• Record Type: Journal Article
• Authors: Johnson, Theodore M.; Markland, Alayne D.; Goode, Patricia S.; Vaughan, Camille P.; Colli, Janet L.; Ouslander, Joseph G.; Redden, David T.; McGwin, Gerald; Burgio, Kathryn L.
• Is Part Of: BJU international. Volume 112:Number 1(2013:Jul.)
• Page Start: 100
• Page End: 108
• Publication Date: 2013-02-28
• Subjects: Genitourinary organs -- Diseases -- Periodicals; Genitourinary organs -- Surgery -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1111/j.1464-410X.2012.11736.x
• Languages: English
• ISSNs: 1464-4096

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bju11736-sec-0001" sec-type="section"> <title>What's known on the subject? and What does the study add?</title> <p> <list id="bju11736-list-0001" list-type="bullet"> <list-item> <p>Nocturia is a common and bothersome lower urinary tract symptom, particularly in men. Many single drug therapies have limited benefit.</p> </list-item> <list-item> <p>For men who have persistent nocturia despite alpha‐blocker therapy, the addition of behavioural and exercise therapy is statistically superior to anticholinergic therapy.</p> </list-item> </list> </p> </sec> <sec id="bju11736-sec-0002" sec-type="section"> <title>Objective</title> <p> <list id="bju11736-list-0002" list-type="bullet"> <list-item> <p>To compare reductions in nocturia resulting from adding either behavioural treatment or antimuscarinic drug therapy to α‐adrenergic antagonist (α‐blocker) therapy in men.</p> </list-item> </list> </p> </sec> <sec id="bju11736-sec-0003" sec-type="section"> <title>Patients and Methods</title> <p> <list id="bju11736-list-0003" list-type="bullet"> <list-item> <p>Participants were men who had continuing urinary frequency >8 voids/day) and urgency after 4 weeks of α‐blocker therapy run‐in and who had ≥1 nightly episode of nocturia.</p> </list-item> <list-item> <p>Participants received individually titrated drug therapy (extended‐release oxybutynin) or multicomponent behavioural treatment (pelvic floor muscle training, delayed voiding and urge suppression techniques).</p> </list-item> <list-item> <p>Seven‐day bladder diaries were used to calculate reductions in mean nocturia.</p> </list-item> </list> </p> </sec> <sec id="bju11736-sec-0004" sec-type="section"> <title>Results</title> <p> <list id="bju11736-list-0004" list-type="bullet"> <list-item> <p>A total of 127 men aged 42–88 years with ≥1 nocturia episode per night were included in the study.</p> </list-item> <list-item> <p>There were 76 men who had a mean of ≥2 nocturia episodes.</p> </list-item> <list-item> <p>Among those with ≥1 nocturia episode, behavioural treatment reduced nightly nocturia by a mean of 0.97 episodes and was significantly more effective than drug therapy (mean reduction = 0.56 episodes; <italic>P</italic> = 0.01).</p> </list-item> <list-item> <p>Participants with ≥2 episodes nocturia at baseline also showed larger changes with behavioural treatment compared with antimuscarinic therapy (mean reduction = 1.26 vs 0.61; <italic>P</italic> = 0.008).</p> </list-item> </list> </p> </sec> <sec id="bju11736-sec-0005" sec-type="section"> <title>Conclusions</title> <p> <list id="bju11736-list-0005" list-type="bullet"> <list-item> <p>Both behavioural treatment and drug therapy reduced nocturia in men with ≥1 episode of nocturia/night when added to α‐blocker therapy.</p> </list-item> <list-item> <p>These results were similar even when only those with ≥2 episodes of nocturia were considered.</p> </list-item> <list-item> <p>The addition of behavioural treatment was statistically better than bladder‐relaxant therapy for nocturia.</p> </list-item> </list> </p> </sec> </abstract>