Significance of nocturnal hesitancy in treatment of men with lower urinary tract symptoms
Received 13 September 2005; accepted 22 November 2005.
Abstract
Objectives
To determine the significance of nocturnal hesitancy in the treatment of men with lower urinary tract symptoms.
Methods
A total of 123 patients with nocturia were prospectively studied. The nocturnal hesitancy scores ranged from 0 to 5 and were scored according to the International Prostate Symptom Score. The patients were stratified on the basis of their nocturnal hesitancy scores as group 1 (0 to 1, n = 57), group 2 (2 to 3, n = 45), and group 3 (4 to 5, n = 21). All patients received treatment with an alpha-blocker once daily for 4 weeks.
Results
Group 3 scored significantly higher on the International Prostate Symptom Score at baseline and after treatment than did group 1. The actual number of nightly voids was greatest in group 3 and was lowest in group 1 (P = 0.011 at baseline and P = 0.046 after treatment, respectively). The baseline nocturia indexes were greatest in group 3 and were lowest in group 2 (P = 0.027). A significant but weak correlation was also noted between the nocturia hesitancy score and the differences in scores between the posttreatment and baseline voiding symptoms (r = −0.234, P = 0.021) and total International Prostate Symptom Score (r = −0.270, P = 0.011), respectively. In our multivariate analyses, the straining score was a significant determinant of nocturnal hesitancy.
Conclusions
The results of our study revealed that more emphasis should be placed on nocturnal hesitancy in the terminology of lower urinary tract symptoms. Additional research regarding the pathophysiologic mechanisms underlying nocturnal hesitancy, as well as its effects on those with it, is clearly warranted.
aDepartment of Urology, Seoul Veterans Hospital, Seoul, Korea
bDepartment of Urology, Seoul National University College of Medicine, Seoul, Korea
Reprint requests: Jae-Seung Paick, M.D., Department of Urology, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea.
ABSTRACT