Older adults often complain of nocturia as one of the most bothersome symptoms of lower urinary tract incontinence. Nocturia places such patients at risk of falling down and insomnia and increases the care burden. The causes of nocturia include various factors, such as neuropathic bladder, prostate hyperplasia and pelvic floor muscle weakness. It has also been reported that nocturia is caused by an increased renal blood flow while lying down and the loss of diurnal variation in vasopressin. The intranasal administration of desmopressin at night may improve nocturia. We experienced a case of severe nocturia that could not be controlled with fluid restriction, urethral catheterization before sleep or anticholinergic drugs. Due to frequent urination during the night, the patient was unable to sleep well and required frequent nursing care. Following the administration of nasal desmopressin before sleep, the number of episodes of nocturia considerably improved. In addition, no adverse events, such as hyponatremia, were observed with desmopressin use. Physicians should therefore consider using desmopressin in cases with treatment-resistant nocturia.

作者：Kensuke, Kayamori；Junko, Fujitani；Shoji, Kawachi

来源：Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics 2014 年 51卷 1期