Multicomponent approach curbs urinary woes in men

By David Douglas

NEW YORK (Reuters Health) - An intervention including drug and behavior therapy may help curb frequent nighttime urination or "nocturia" in elderly men, researchers have found.

"Nocturia is bothersome for patients and is often challenging for clinicians to treat," lead investigator Dr. Camille P. Vaughan told Reuters Health. "This research highlights that multiple causes of nocturia often coexist in individual, elderly men."

Vaughan, from Emory University School of Medicine, Atlanta, and colleagues studied 55 men aged 50 or older who reported making two or more nightly trips to the bathroom, on average.

The team defined nine associated or underlying conditions to help direct treatment for their nighttime urinary woes.

Among the most common were an enlarged prostate -- a condition known as benign prostatic hyperplasia or BPH, seen in 87% of men, high blood pressure (86%) and going to the bathroom eight or more times during the day (71%). Another was difficulty in returning to sleep.

All of the men received behavioral interventions, which included advice on reducing caffeine and alcohol, limiting nighttime fluids and paying attention to room temperature, noise, and lighting. Drug therapy -- for BPH, frequent urination, and sleep issues -- was also started where appropriate.

After 4 weeks, the men reported a significant decrease in nighttime trips to the bathroom. The men in general also reported feeling significantly less bothered by the condition.

The men also reported significant improvements in the time it took them to get to sleep, fall back to sleep and their overall quality of sleep.

SOURCE: BJU International, July 2009.