Which are effective treatments for Reducing Nocturia among Women with Overactive Bladder?

In a recent study, researchers have shed light on the efficacy of various treatments for a common symptom of overactive bladder (OAB) known as nocturia. The secondary analysis study found that for women with nocturia of at least 2 voids per night, treatment with anticholinergic medication, onabotulinum toxin A (BTX) (either 100 or 200 units), or sacral neuromodulation (SNM) resulted in a significant decrease in the number of voids per night at the 6-month follow-up.

The study results were published in the journal Urogynecology.

Nocturia, characterized by waking up multiple times during the night to urinate, can significantly impact the quality of life of those affected. The prevalence of nocturia among individuals with overactive bladder underscores its significance as a distressing symptom, yet there remains a notable gap in our understanding of how various treatments for overactive bladder affect this nocturnal urgency. The study, conducted by analyzing data from the ABC and ROSETTA trials, aimed to compare the effectiveness of anticholinergic medication, onabotulinum toxin A (BTX), and sacral neuromodulation (SNM) in reducing nocturia.

A team of researchers from MedStar Washington Hospital Center, Washington D.C., by utilizing the National Institutes of Health Data and Specimen Hub database, conducted a study that included 197 female patients who reported a mean of at least 2 voids per night on a 3-day diary. These patients were divided into cohorts based on the treatment they received: anticholinergic medication, BTX 100 units, BTX 200 units, or SNM. The main outcome was to measure the change in mean voids/night on 3-day diary from baseline to 6 months.

Findings:

• One of the key findings of the study was that all treatment cohorts demonstrated a significant reduction in the mean number of voids per night at the 6-month mark.
• This reduction was a substantial 41% in mean voids per night, marking a significant improvement in the nocturia symptoms experienced by the participants.
• Importantly, this improvement was observed across all treatment modalities.
• Prior to treatment initiation, there were no significant differences noted among the cohorts in terms of the number of voids per night, demographic factors, or urodynamic values.
• However, after 6 months of treatment, the results showed consistent and substantial improvements across the board, regardless of the treatment method utilized.

Notably, the study found no significant differences in the effectiveness of the various treatments in reducing nocturia. Whether patients received anticholinergic medication, BTX (either 100 or 200 units), or SNM, the reduction in the mean number of voids per night was comparable across all groups. This suggests that multiple treatment options are equally effective in addressing the bothersome symptoms of nocturia in women with OAB.  

Further reading: Comparing Impact of Overactive Bladder Therapies on Nocturia. DOI: 10.1097/SPV.0000000000001465