A NOVEL THERAPY FOR NOCTURNAL POLYURIA - A DOUBLE-BLIND RANDOMIZED TRIAL OF FRUSEMIDE AGAINST PLACEBO

Objective To report a randomized, double-blind, placebo-controlled tri al of an afternoon dose of the diuretic frusemide, used to establish a n early evening diuresis and so diminish nocturnal voiding frequency a nd voided volume in elderly men presenting with lower urinary tract sy mptoms (LUTS). Patients and methods After a 2-week placebo run-in peri od, 49 men aged > 50 years were randomized to receive 40 mg of frusemi de or placebo. taken 6 h before their usual bedtime. Day and night-tim e frequency and voided volume during the run-in and treatment periods were compared between the placebo and frusemide groups. Results In the 43 men completing the study, there was a significant reduction in nig ht-time frequency (-0.5 and 0) and percentage night-time voided volume (-18% and 0%) in those taking frusemide compared with placebo. Of pat ients on active treatment, seven of 19 had a reduction in night-time f requency of greater than or equal to 1, compared with only one of 20 o n placebo, and 14 of 21 felt that frusemide had helped their nocturia, compared with only five of 22 on placebo. Conclusion Men with LUTS wh ose most prominent symptom is nocturia should complete a frequency-vol ume chart. In those with nocturnal polyuria, 40 mg of frusemide result ed in a significant reduction in night-time frequency and percentage v oided volume.