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Can treatment of nocturia increase testosterone level in men with late onset hypogonadism?
By J.W. Kim, J.Y. Chae, J.W. Kim, C.Y. Yoon, M.M. Oh, H.S. Park, J.J. Kim and G. du Moon
Urology, Volume 83, Issue 4, April 2014, Pages 837-842
The rationale of the present article comes from the observation that in healthy adult men testosterone concentrations are high around waking time and decrease during the day, a behaviour often referred to a circadian rhythm. As disturbed sleep affects the nocturnal increase in testosterone levels, reducing the number of nocturnal wake ups due to the need of voiding, could restore testosterone values and sexual function. In the present prospective, open- label non- placebo controlled study, 62 men aged >40 yrs with nocturia and symptoms of late onset hypogonadism have been included. At baseline, patients underwent frequency-volume charts, testosterone serum levels, IPSS questionnaire, International Index of Erectyl Function questionnaire and Aging Male’s Symptom scales. Then they were treated with desmopressin 0.1 mg/day for 12 weeks and re-evaluated again with the same modalities. The Authors could observe that nocturnal urine volume, nocturnal polyuria index, number of nocturia events, nocturia index, and nocturnal bladder capacity index significantly decreased on the frequency volume chart. After 12-week treatment Desmopressin not only improved nocturia, but also induced a significant increase in testosterone serum levels in these men with low values. As explanations, the Authors hypothesized that a link exists between testosterone replacement and normal AVP expression in the brain, and that testosterone plays a role in maintaining reflex activity in the pelvic portion of the autonomic nervous system.