Long-Term Desmopressin Treatment Is Effective and Safe for Nighttime Urination in Older Men

Retrospective study at Chikugo City Hospital (August 2020 – December 2022) involving 133 men with nocturnal polyuria. Patients received an initial dose of desmopressin 50 μg. Efficacy was assessed using 3-day frequency-volume charts at baseline and 1, 4, 12, 24, and 52 weeks. Safety was monitored through BNP levels and chest X-ray (cardiothoracic ratio) at baseline and 52 weeks.

Nocturia is one of the most common and bothersome urinary symptoms in older adults, severely affecting sleep quality and increasing fall risk. While desmopressin is effective, concerns about water retention and cardiac effects in elderly patients have limited long-term use. This study provides reassuring real-world evidence that the peptide drug can be used safely for at least one year in older men.

Desmopressin is a classic example of a therapeutic peptide — a synthetic analog of the natural hormone vasopressin (antidiuretic hormone). Originally developed for diabetes insipidus and bedwetting, its use has expanded to adult nocturia. This study helps address the safety gap for long-term use in elderly patients, a population where nocturia is most prevalent but also where fluid-related risks are highest.

This was a retrospective, single-center study without a control group or blinding. The BNP increase, while not accompanied by cardiac structural changes, warrants monitoring. Only men were included, so results may not apply to women. The study did not track sodium levels, which can drop dangerously with desmopressin use (hyponatremia). Some patients may have dropped out due to side effects, potentially biasing the 87.6% improvement rate.