Real-world safety and effectiveness of an initial 0.1 mg dose of desmopressin in older men with nocturnal polyuria.

To investigate safety and effectiveness of oral desmopressin tablet (starting dose 0.1mg) in older Taiwanese men with nocturnal polyuria and nocturia, and to compare results in those aged ≥80 years vs <80 years.

234 Taiwanese males aged ≥60 years with nocturia (≥2 voids/night) and a nocturnal polyuria index of ≥33 were included. Patients received desmopressin 0.1 mg for up to 3 months. Effectiveness was evaluated at Month 1, and safety was assessed at Month 1, 2 and 3.

208 patients (88.9%) aged 60-95 provided follow-up data. 70.1% of participants completed the 3-month treatment period. Desmopressin was associated with significantly reduced median nocturnal voids/night (<80 yrs: -2.0; ≥80 yrs: -3.0) and urine volume (<80 yrs: -705 mL; ≥80 yrs: -660 mL), and increased hours of undisturbed sleep (<80 yrs: 1.0 h; ≥80 yrs: 2.0 h; all p<0.001). 39/234 (16.7%) discontinued desmopressin due to hyponatremia (determined via serum sodium monitoring). 28 patients with serum sodium decreases to ≤135 mmol/L continued treatment for the full 3 months with appropriate dose adjustments.

This study provides real-world evidence of effectiveness and safety of oral desmopressin in an older Asian male population, including a subgroup aged >80 years. A starting dose of 0.1 mg oral desmopressin, coupled with careful serum sodium monitoring and dose adjustment if required, was associated with significant improvement in all nocturia parameters and a high rate of continuation.

The Journal of urology. 2026 Feb 20 [Epub ahead of print]

Cheng Chu, Chih-Chieh Lin

Department of Urology, Taipei Veterans General Hospital, Yuanshan and Su-Ao Branches., Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan.