Aim and background: Chronic insomnia in elderly patients significantly affects their health and quality of life (QOL). Nocturia also worsens sleep condition. The aim of this study was to evaluate the improvement effects of quazepam, a long-term acting benzodiazepine, on insomnia and nocturia in elderly patients. Method: Forty-one elderly outpatients (mean age 77.1 ± 5.6 yr) suffering from chronic insomnia while on regular a short- or ultra-short-acting hypnotic treatment were enrolled. We prescribed 7.5-15 mg of quazepam, which was administered regularly by the subjects before bedtime. A questionnaire was used to compared changes in quality of sleep and frequency of nocturia for before treatment and at 2 and 4 weeks after initiation of treatment. QOL was also examined using the 36-item Short Form Health Survey of the Medical Outcomes Study (SF-36). Results: Thirty-seven subjects (90.2%) completed the study. All subscales of the sleep quality questionnaire improved significantly (p<0.001) after 2 weeks, as did the total scores (p<0.001) after 4 weeks. Frequency of nocturia decreased significantly from 3.6 ± 1.7 times to 1.5 ± 0.8 (p<0.001) and 1.2 ± 1.0 times (p<0.001) after 2 and 4 weeks, respectively. Every SF-36 subscale also showed significant improvement after 4 weeks. The total SF-36 scores of the group showing a decrease in the frequency of nocturia (>/= 2 times) improved significantly compared with that with a frequency of < 2 times (p=0.016). Conclusion: Quazepam significantly improves sleep, QOL and nocturia in elderly patients that respond poorly to short-acting or ultra-short-acting hypnotics.
Nycturia ; Elderly ; week ; lower case pea ; Sleep

Patients with Benign Prostatic Hyperplasia (BPH) commonly presents with lower urinary tract symptoms (LUTS), which can be of obstructive symptoms such as hesitancy, incomplete voiding, post void dribbling or of irritative symptoms such as urgency, frequency and nocturia. Various recent studies indicate that nocturia is a very important and bothersome lower urinary tract symptom especially among patients with Benign Prostatic Hyperplasia (BPH). The aim of the study was to determine the frequency of common urinary symptoms among patients with BPH in HUSM as well as to evaluate the extent of bothersomeness of each and every symptom to these patients. This study too was aimed at evaluating the success of TURP in resolving pre operative LUTS. This was a questionnaire-based survey using a validated ICSBPH model whereby patients with BPH were selected and quizzed personally by an investigator. A subset of patients who had undergone TURP was further questioned regarding their satisfaction with the procedure. When nocturia is defined as waking up at night once or more to pass urine, the prevalence of nocturia was about 90%, but only 1 in 6 patients considered this is a very serious symptom. Even if the definition was changed to waking up twice or more, the prevalence is still quite high at over 80%. Urgency was noted in half of the patients, but only a quarter of them consider it a serious problem. 1 in 5 patients experienced significant leak and almost all consider it serious. About one third of the studied population had to be catheterized due to urinary obstruction and interestingly only about half of them considered it as a very serious event. Overall, a great majority of these patients considered suffering from these urinary symptoms for the rest of their life as very devastating. This study concludes that although the prevalence of nocturia was high among BPH patients, but it was not considered serious by majority of them. In fact, LUTS in our BPH patients did not differ much from BPH patients elsewhere. On the whole, TURP resolved most of the LUTS effectively.
symptoms <1> ; Prostatic Hypertrophy, Benign ; Nycturia ; Benign ; Urinary Tract

In a prospective open uncontrolled study, Beta-Sitosterol( cholesterol lowering agent) was investigated in the treatment of benign prostatic obstruction, Forty patients were included in the study. All patients were treated with 60mg of Beta-Sitosterol daily for 3months. Mean maximum and average flow rates were increased significantly. Volume of residual urines were reduced from an initial 52ml to 30ml in the final weeks(p <0.001). The mean intervals of diuria were increased from an initial 1.7 hour to 2.6hour and the frequencies of nocturia were reduced from an initial 2.1times to 1.8times in the final weeks(p<0.001), Other obstructive symptom were subjectively improved. Side effects were minimal. It was concluded that the Beta-Sitosterol at a dose of 20mg tid is a safe and effective therapeutic alternative in patients with benign prostatic obstruction and may be used in patients awaiting surgery and those who unfit for operation.
Cholesterol ; Humans ; Nocturia ; Prospective Studies ; Prostatic Hyperplasia

PURPOSE: It is well known that nocturia is a bothersome symptom that affects the quality of life (QoL). However, it is not known how much of a decrease in nocturnal frequency is needed to improve the QoL. We determined the minimal change in nocturnal frequency affecting the QoL of patients with nocturia. MATERIALS AND METHODS: A total of 87 patients with BPH and nocturia were treated with alpha-blocker and desmopressin for 8 weeks. Considering that the minimal clinically important change (MCIC) is different according to the baseline value, we divided the patients into two groups (group I, II). Group I had mild to moderate nocturia with voiding <4 times per night, and Group II had severe nocturia with voiding > or =4 times per night. Voiding diaries and King's Health Questionnaires (KHQs) were evaluated before and after treatment. To determine the minimal change in nocturia affecting the QoL, statistical analysis was performed by Student's t-test and ANOVA test with the change in KHQ score according to decreased numbers of nocturnal frequency. RESULTS: Groups I and II had 35 and 52 patients, respectively. The minimal decrease in nocturnal frequency associated with a statistically significant decrease in sleep/energy domain scores was 1 time in Group I and 2 times in Group II. CONCLUSIONS: These data show that decreases in nocturia of at least 1 time in patients with mild to moderate nocturia (<4 times/night) and of 2 times in patients with severe nocturia (> or =4 times/night) are needed to improve the QoL.
Deamino Arginine Vasopressin ; Humans ; Nocturia ; Quality of Life

PURPOSE: It seems that nocturia is not improved even after various forms of treatment in benign prostatic hyperplasia(BPH) patients. We studied the relationship of nocturia with other components of the International Prostate Symptom Score(IPSS) in BPH patients and also evaluated the changes of nocturia score following medical or surgical treatments to determine whether the nocturia score behaves differently. MATERIALS AND METHODS: Between March 2002 and March 2004, a total of 198 men with BPH were enrolled in this study. Baseline symptom scores and the change after treatment were analyzed particularly focused on nocturia score. RESULTS: On baseline score analysis, the nocturia score correlated with frequency and urgency scores(p=0.01). Total IPSS score was changed from 21.8+/-6.5 to 10.1+/-6.7 after treatment(p<0.001). The changes of nocturia score were 2.4+/-1.2 to 1.8+/-1.1 in the younger group and 3.1+/-1.3 to 2.2+/-1.2 in the older group, 2.9+/-1.3 to 2.1+/-1.1 in the surgical treatment group and 2.3+/-1.2 to 1.7+/-1.1 in the medical treatment group. The improvement of nocturia score was minimal after treatment. CONCLUSION: It seems that nocturia score behaves differently in the symptom complex of BPH. These facts should be considered when we consult patients with BPH complaining of nocturia.
Humans ; Male ; Nocturia* ; Prostate ; Prostatic Hyperplasia*

PURPOSE: We evaluated the long-term effects of loxoprofen on nocturia in patients with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: Between January 2006 and December 2008, 40 BPH patients with 2 or more episodes of nocturia received an alpha-blocker, 5-alpha reductase inhibitor, and a single dose of 60 mg of loxoprofen at night before sleep for 12 months (Group I). During the same period, 38 BPH patients selected as the control group received an alpha-blocker and 5-alpha reductase inhibitor (Group II). Patients were reevaluated after 3, 6, and 12 months of treatment by the number of nocturia episodes and side effects. RESULTS: After 3 months of treatment, the number of nocturia episodes decreased significantly compared with baseline in both group I and group II (1.9+/-0.7, 2.1+/-0.7, respectively, p<0.05). The degree of decrease in nocturia was significantly different between the groups (-1.5+/-0.9, -1.1+/-0.9, respectively, p=0.034). After 6 and 12 months, the number of nocturia episodes decreased significantly compared with baseline in both group I and group II (p<0.05), but the degree of decrease was not significantly different between the groups (p>0.05). After 6 and 12 months of treatment in group I, treatment-emergent adverse events, including 5 cases of gastric discomfort (12.5%), 3 cases of leg edema (7.5%), and 1 case of decreased urine volume (2.5%), occurred in 9 of the 40 (22.5%) patients. CONCLUSIONS: Loxoprofen can be an effective treatment for patients with nocturia secondary to BPH in the short term. Long-term use of loxoprofen is not recommended because of the side effects.
Edema ; Humans ; Leg ; Nocturia ; Oxidoreductases ; Phenylpropionates ; Prostatic Hyperplasia ; Sodium

PURPOSE: We tried to discover the normal voiding pattern, which was diurnal & nocturnal urinary volume, voiding frequencies in healthy older men without prostate disease. MATERIALS AND METHODS: All voided volumes, times and frequencies were recorded for 3 days in 158 healthy men without any voiding problems. The subjects ages ranged from 31 to 49 for 47 men (mean age 42.8), 50 to 59 for 38 men (mean age 54.1), 60 to 69 for 39 men (mean age 67.3), 70 to 81 for 34 men (mean age 74.5). The subjects age related changes in bladder capacity, urinary volume and frequency were evaluated. The causes of nocturnal urinary frequency and its increase with age in healthy older men were evaluated using 3 days of voiding diaries. Nocturia was devided into three types: nocturnal polyuria, decreased nocturnal bladder capacity and mixed type. RESULTS: Nocturnal bladder capacity, functional bladder capacity, total urinary voiding volume and daytime urinary voiding volume decreased with age. Nocturnal urinary frequency increased with age. Nocturnal urinary volume did not change with age. 76 (48%) of the 158 volunteers had 2 or more voidings per night. 9 (12%) of the 76 volunteers had nocturnal polyuria. 39 (51%) had decreased nocturnal bladder capacity, and 28 (37%) had mixed type. CONCLUSIONS: Normal voiding patterns changed with age, especially in subjects over 60 years. In most cases, nocturia was caused by decreased nocturnal bladder capacity, since nocturnal urinary volume did not change with age but nocturnal bladder capacity decreased with age.
Adult* ; Aging ; Humans ; Male* ; Nocturia ; Polyuria ; Prostate ; Urinary Bladder ; Volunteers

The understanding of nocturia has been much changed in last decade. Recently, nocturia has been recognized as a separate clinical entity within the lower urinary tract symptom complex. The pathophysiology of nocturia is multifactorial and can be complex and its cause remains unclear in a significant number of patients. Although the successful introduction of DDAVP to decrease nocturnal urine output in severe nocturia resistant to conventional treatment demonstrated new perspectives in management of nocturia, the primary treatment modality must be based on the disease. We reviewed the definition and etiologies of nocturia, offering the current diagnostic procedures and standards of care and we suggest practical tip for the management of nocturia.
Deamino Arginine Vasopressin ; Humans ; Nocturia ; Standard of Care ; Urinary Tract ; Urology

PURPOSE: The precise etiology and classification of nocturia in women is not enough. We evaluated age related changes and classified the type of nocturia by age in women. METHODS: We included 118 women 20 years or older with nocturia at least one time during night time. Subjects were divided into three groups by the age: group 1, under 40 years; group 2, 40 through 59 years; group 3, 60 years and above. The causes of nocturia and its pattern changed by age in women were evaluated using 3 days frequency volume chart. Nocturia was devided into three types: nocturnal polyuria, decreased nocturnal bladder capacity and mixed type. RESULTS: The mean age was 57.2+/-11.8 and the mean nocturnal frequency was 2.7+/-1.8. In all age group, noctural polyuria was the major cause for noturia (40.8%), followed by low nocturnal bladder capacity (23.7%). As a major cause of nocturia, there was a significant increase of the incidence of nocturnal polyuria in aged people: group 1, 32.4%; group 2, 41.0%; group 3: 47.6% (P<0.04). CONCLUSIONS: Nocturnal polyuria and decreased nocturnal bladder capacity are the major causes of nocturia in women. Nocturnal polyuria was the major cause of nocturia with age over 60 years old. In aged women, nocturnal polyuria should be considered as a main cuase of nocturia and treated based on these result.
Aged ; Female ; Humans ; Incidence ; Nocturia ; Polyuria ; Urinary Bladder

PURPOSE: We tried to discover the voiding patterns, which was diurnal & nocturnal urinary volume and voiding frequencies in women with overactive bladder (OAB). MATERIALS AND METHODS: All voided volumes, times and frequencies were recorded in 249 women with overactive bladder. The subjects age related changes in bladder capacity, urinary volume and frequency were evaluated. The causes of nocturnal urinary frequency and its increase with age in older women with OAB were evaluated using 3 days of voiding diaries. Nocturia was devided into three types: nocturnal polyuria, decreased nocturnal bladder capacity and mixed type. RESULTS: Total voided volume, daytime urine volume, functional bladder capacity were decreased with the age. Nocturnal urine volume and nocturnal urinary frequency were increased with age. Nocturnal polyuria was the major cause for nocturia, and mixed type was increased with age. CONCLUSIONS: Voiding symptoms as well as storage symptoms were increased with age in OAB female. In most cases, nocturia was caused by nocturnal polyuria.
Aging ; Female ; Humans ; Nocturia ; Polyuria ; Urinary Bladder ; Urinary Bladder, Overactive*