Nocturia: A non‐specific but important symptom of urological disease

Abstract

Nocturia is a prevalent symptom that can adversely affect quality of sleep and overall quality of life leading to morbidity and even mortality. Nocturia can be due to a range of urological conditions and non-urological diseases. Nocturia can be due to an insufficient bladder capacity and/or (nocturnal) polyuria. Some of the possibly underlying non-urological diseases can be life-threatening, implying treatment priorities. Urological treatment options include a-adrenoceptor antagonists, muscarinic receptor antagonists and vasopressin receptor agonists. The former two have shown beneficial but small and inconsistent effects in patients assumed to have benign prostatic hyperplasia or overactive bladder, respectively. In contrast, the vasopressin analog desmopressin has consistently shown nocturia improvement in patients with proven polyuria. While supported by lower levels of evidence, lifestyle modifications are generally considered important for nocturia treatment. We conclude that nocturia is a urinary storage symptom with a major impact on patients' lives and a complex pathophysiology.

Prevalence and risk factors for nocturia in middle-aged and elderly people from public health centers in Taiwan

“…Thus, it is logical to hypothesize that the association between the effects of hyperglycemia may, at least in part, affect the occurrence of nocturia. In addition, the lack of arginine vasopressin (AVP) secretion and renal AVP resistance induced by diabetes may play a crucial role (20,21). People with obesity (BMI of > 27 kg/m 2 ) had higher odds for suffering from nocturia, as compared to those without obesity, which was consistent with numerous epidemiological studies (5,7,8,15,17).…”

“…The causes for nocturia were previously classifi ed as diurnal polyuria, nocturnal polyuria, low functional bladder capacity, or a combination of these, and the plasma AVP and ANP may be crucial humoral factors (21,29). In our study, nocturia was signifi cantly associated with several illnesses, and some plausible mechanisms or hypotheses are proposed to explain these relationships.…”

The impact of adding low-dose oral desmopressin therapy to tamsulosin therapy for treatment of nocturia owing to benign prostatic hyperplasia

“…nocturia does not completely respond to BPH medical treatment and alleviation of bladder outlet obstruction is not enough to overcome nocturia. this could be explained by the multiple etiologies of nocturia in aging men [16] that lead to persistence of nocturia in a significant proportion of patients even after treatment of prostate obstruction. nocturia may be the result of behavioral, physiological or pathologic factors.…”

The Effect of Robot-Assisted Laparoscopic Prostatectomy on Nocturia

“…[5][6][7][8] For example, decreased time spent in delta wave sleep, decreased renal concentrating ability, age-related detrusor instability, and mechanical obstruction from the prostate all likely contribute to nocturia. 9,10 Related to this, as our understanding of the causes of nocturia and its impact on sleep cycles has evolved, so have our interventional options and medical regimens to alleviate the mechanical obstruction of an obtrusive prostate.…”