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Medical Therapy for BPH and OAB

BPH and OAB Medication

  • Standard medications to treat OAB include anticholinergics such as oxybutynin (Ditropan) and tolterodine (Detrol). These medications provide a modest 0.3 fewer times up to urinate at night.
  • BPH medication such as tamsulosin (Flomax) and alfuzosin (Uroxatral) have similar results

Topical vaginal estrogen

  • For postmenopausal women with continued nocturia despite other treatments, it is reasonable to add topical vaginal estrogen to other therapies.

Nocturia Specific Medication

Desmopressin or ddAVP

  • This medication works to decrease urine production at night.  The oral version of this medication is not FDA approved but can be used off-label to treat nocturia.  There is a new intranasal form that is FDA approved for nocturia.
    • In clinical trials of intranasal ddAVP (Noctiva™), individuals ≥age 50 years with a baseline of 3.3 episodes of nocturia per night decreased to 2.1 episodes with placebo and 1.9 per night with Noctiva.  This means getting up 1.4 fewer times to urinate.
    • There have been studies in men with nocturia using oral ddAVP to treat nocturia.  These studies show that patients get up 0.7 fewer times to urinate using this version of the drug.

Please click here for more information on Noctiva™ .

Procedures for BPH and OAB

Treatment for BPH and OAB may also help with nocturia.  This may include procedures or advanced therapies.  See the BPH and OAB pathways on this website for more information. (Insert links)

BPH procedures:

  • TURP
  • Other transurethral procedures

OAB procedures:

  • Posterior tibial nerve stimulation
  • Intravesical BOTOX
  • Sacral nerve stimulation

Combination Therapy

Making several changes in your overall health and daily routine offers the best chance at successfully improving your nocturia.   Maximizing treatment of other other medical conditions and continuing behavior/lifestyle modifications is essential.

These steps may include improvement in:

  • Diabetes and heart disease management
  • Treatment of depression
  • Exercise
  • Sleep hygiene (including obstructive sleep apnea)
  • Fluid management
  • Daytime compression stockings
  • Medication
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