Nocturnal Polyuria Can Be Improved by Siolodosin Medication

Nocturnal Polyuria Can Be Improved by Siolodosin Medication

Elederly men, namely patients with benign prostatic hyperplasia (BPH), produce a large volume of urine while sleeping. This condition, known as nocturnal polyuria (NP), forces them to go to the bathroom during the night, decreasing their quality of sleep. Current medication with desmopressin may cause low blood-sodium level, which results in side effects of hyponatremia such as nausea and vomiting.

To find alternative therapies for the management of NP in elderly BPH patients, Korean researchers evaluated the effectiveness of silodosin, included in a group of medicines known as α-blockers, in improving NP in elderly BPH patients. The study entitled “The Effectiveness of Silodosin for Nocturnal Polyuria in Elderly Men With Benign Prostatic Hyperplasia: A Multicenter Study” was supported by the JW pharmaceutical company and published in International Neurourology Journal.

The  team enrolled BPH patients diagnosed with NP who were aged ≥60 years. Based on a 3 days and nights record to assess water intake and urine volume, they selected patients with a nocturnal polyuria index (NPi) >0.33. They found that patients followed up for 12 weeks after silodosin initiation showed an improvement based on the International Prostate Symptom Score (IPSS). Silodosin also improved sleep quality in NP patients; however, in many cases, there was no improvement in nocturnal polyuria itself.

“These results suggest that silodosin could be a useful drug for managing NP in elderly BPH patients without serious adverse events. However, the mean NPi was not decreased to lower than 0.33. Silodosin, therefore, did not improve NP,” wrote the authors in their study.

Considering the general improvement of all patients, silodosin may work as an alternative to avoid side effects of desmpressin, a synthetic replacement for vasopressin, the hormone that reduces urine production. However, the reduced number of patients included in this study due to a high dropout rate requires larger trials to confirm these results. “We suggest that silodosin can be an alternative option to treat NP and nocturia in elderly BPH patients with a risk of hyponatremia before trying desmopressin. Of course, additional randomized, double-blind comparative studies comparing the efficacy of silodosin versus other α-blockers for treating nocturia and NP should be performed,” the authors suggested.

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Teresa F. Pais holds her PhD in Biomedical Sciences from University of Porto. She has worked in innate immune responses in the context of both infection and neurodegeneration. Currently, she is a researcher at Instituto de Medicina Molecular where she investigates inflammatory processes in the brain.

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