Tamsulosin Reduces Night Time Urine Production in Nocturnal Polyuria Due to BPH: A Single-Arm, Open-Label, Prospective Study

Introduction

Nocturia

• Interrupts sleep
• Decreases Quality of Life

• Increases morbidity and mortality

Nocturnal polyuria (NP) is an important cause of nocturia

Possible underlying mechanism:

• Decreased catecholamine levels at night vs daytime
• This increases night time renal blood flow causing increased night time urine production
• Concomitant decreased daytime urine production feeds into redirection of increased extracellular fluid during daytime for night time urine production

Aim

• To assess effect of tamsulosin on night (and day) time urine production, number of nocturia episodes, IPSS, quality of life and Q_max
• To explore and understand possible underlying mechanisms behind overall effect of Tamsulosin on NP.

Methods

Patient Population

• Setting: Outpatient department in Nagoya, Japan
• Data from 58 patients with NP due to BPH

Intervention

• 0.2 mg of Tamsulosin once daily

Results

Significant decrease (p < 0.05) in:

• IPSS (i.e. Improvement in LUTS)
• QoL index (i.e. Improvement in Quality of Life)
• Mean night time urine production
• Number of nocturia episodes

Significant increase (p < 0.05) in:

• Q_max (i.e. Increased Peak Urinary Flow Rate)
• Mean daytime urine production

Among patients with NP due to BPH over 4 years

Conclusions

• Tamsulosin reduces nocturnal polyuria due to BPH by decreasing night time urine production over the long term
• Probable underlying mechanism is by tamsulosin increasing daytime urine production by increasing daytime renal blood flow, which is deficient in NP patients

Neurourol Urodyn. 2012 Jan;31(1):80-5. Doi: 10.1002/nau.21224.