Aim: We aimed to clarify the impact of night-time dosing with tolterodine extended release (ER) on nocturia.
Methods: The bladder diaries, urodynamic studies, and medical records of female patients with overactive bladder syndrome who were diagnosed between January 2005 and December 2015, and treated with tolterodine ER 4 mg once per day (night-time or daytime dosing) for 12 weeks in the urogynecology outpatient clinics of two tertiary referral centers were reviewed retrospectively.
Results: A total of 72 female patients were reviewed. Thirty-six patients were in the daytime dosing group, and the other 36 patients were in the night-time dosing group. In the daytime dosing group, a decrease in the volume of fluid intake was found at 06.00-12.00, 12.00-18.00, and 18.00-24.00 hours, and a decrease in total voided volume was found at 12.00-18.00, 18.00-24.00, and 24.00-06.00 hours with a between-group difference at 18.00-24.00 hours (coefficient = 542 mL, P = 0.01). In the night-time dosing group, an increase in voided volume per micturition was found at 06.00-12.00 and 24.00-06.00 hours with a between-group difference at 24.00-6.00 hours (coefficient = 92 mL, P = 0.003) compared with the daytime dosing group. Nonetheless, pre-treatment proportions of nocturnal polyuria did not differ from post-treatment proportions (night-time: 20% vs 20%, P = 1.00; daytime: 48% vs 42%, P = 0.48). Decreases in the number of voiding and urgency episodes at nearly all time periods and increases in the volumes at strong desire to void were also found in both groups.
Conclusion: Night-time dosing of tolterodine ER may benefit female patients suffering from nocturia due to a greater voided volume per micturition at midnight.
Keywords: lower urinary tract symptoms; muscarinic antagonists; nocturia; overactive; urinary bladder; urodynamics.
© 2017 Japan Society of Obstetrics and Gynecology.