Desmopressin in the treatment of nocturnal polyuria in the male

Objectives. To assess whether desmopressin (1-desamino 8-D-arginine vasopre ssin) is safe and effective in the treatment of nocturnal polyuria in elder ly men. Patients and methods. Twenty men (age 52-80 years) complaining of nocturia were found to have nocturnal polyuria, determined from frequency-volume cha rts and defined as the production of >33% of the 24 h urine volume overnigh t, averaged over a 1-week period. Tn a double-blind study of cross-over des ign, a 1-week placebo run-in period was followed by two 2-week periods of p lacebo or 20 pg intranasal desmopressin, and ended with an open 2-week trea tment period with 40 mu g desmopressin. Results. Desmopressin caused a significant reduction in nocturnal urine vol ume and the percent-age of urine passed at night, but the reduction in noct urnal frequency was only significant during treatment with 40 mu g desmopre ssin. Four patients on desmopressin experienced side-effects, three of whic h were thought: to be due to fluid retention. Conclusion. Desmopressin is an effective treatment for nocturnal polyuria i n some elderly men. However, it can cause fluid retention and should not be given to patients with cardiac failure. Those undergoing treatment must be closely monitored.