Nocturia and its impact on health-related quality of life and health care seeking behaviour in German community-dwelling men aged 50 years or older

Oelke, Matthias; Wiese, Birgitt; Berges, Richard

doi:10.1007/s00345-014-1374-6

Cited by 34 publications

(40 citation statements)

References 23 publications

(19 reference statements)

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“…In men >70 years of age, the prevalence rates of nocturia ≥1 times per night rose to 68.9-93.0 % and ≥2 times per night to 29.0-59.3 %. This topic issue of the World Journal of Urology on nocturia also contains the first report on nocturia in German community-dwelling men in which 87 % of men aged 50-80 years reported about nocturia ≥1 times per night and 43 % of men ≥2 times per night [5]. This study confirmed the high prevalence rates in Germany and is in line with the results of other epidemiological studies.…”

Section: Epidemiologysupporting

confidence: 80%

“…Although the perception of bother associated with nocturia largely depends on the individual, the FINNO study reported bother from nocturia when the individual has to void at least 2 times per night (i.e., clinically relevant nocturia) [3]. The German epidemiological study on nocturia, first presented in this topic issue, confirmed this threshold value in adult men and showed that ≥2 voids per night significantly reduces HRQoL (as measured by the SF-12 questionnaire and the IPSS-QoL index) and is the only symptom of all LUTS captured on the IPSS questionnaire that triggers medical consultations in the 2-year follow-up period [5]. The higher the nocturnal voiding frequency was, the more deteriorated the HRQoL became.…”

Section: Health-related Quality Of Lifementioning

confidence: 63%

“…(4) There is a high placebo effect when treating nocturia in patients with LUTS/BPH, indicating that behavioral and lifestyle modifications under controlled study situations substantially add to treatment effects. (5) Despite the low mean reduction of nocturnal voids, 38-69 % of patients report about nocturia improvement of ≥1 void/night, and 26-44 % of men with ≥2 voids/night at baseline have <2 voids/night at study end, indicating a clinically relevant improvement of and only a minor amount of bother from nocturia [3,5].…”

Section: Treatmentmentioning

confidence: 99%

“…(2) The mean number of nocturnal voids per night in patients with the clinical diagnosis LUTS/BPH is between 2.3 and 3.0. This nocturia frequency indicates that the majority of patients with LUTS/BPH experience bother and reduced HRQoL from nocturia [3,5]. (3) The reduction of the nighttime voiding frequency with LUTS/BPH drugs is only modest compared to placebo or active comparator, and the difference is approximately 0.2 voids per night, regardless of the drug class.…”

Section: Treatmentmentioning

confidence: 99%

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Nocturia: state of the art and critical analysis of current assessment and treatment strategies

et al. 2014

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This editorial of the topic issue of the World Journal of Urology provides a state of the art on nocturia which includes descriptions of the terminology, epidemiology, health-related quality of life, medical and financial consequences, pathophysiology, assessment tools and treatment strategies of nocturia. This summary also includes a flowchart on the pathophysiology of nocturia with illustration of the various causes of reduced bladder capacity, increased fluid intake or increased diuresis; a flowchart with the key findings of frequency-volume charts to determine the underlying pathophysiology; and a flowchart on the treatment of the various causes of nocturia. The editorial critically discusses current assessment and treatment strategies in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) and nocturia. The outcome of nocturia remains hidden in drug trials of patients with LUTS/BPH because nocturia-specific measures were not included. The authors recommend using frequency-volume charts, measurement of the hours of undisturbed sleep, and nocturia-specific quality of life questionnaires (e.g., ICIQ-N or N-Qol) in all future studies in patients with LUTS/BPH and nocturia.

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Section: Epidemiologysupporting

confidence: 80%

Section: Health-related Quality Of Lifementioning

confidence: 63%

Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

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Nocturia: state of the art and critical analysis of current assessment and treatment strategies

et al. 2014

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“…Healthcare-seeking behavior is triggered by LUTS severity and LUTS phenotypes. Men often consult their doctors when they have severe LUTS or experience urinary urgency or nocturia [1,3]. LUTS/BPH have a multifactorial etiology and can be caused by the prostate, bladder, urethra, pelvic floor, central or peripheral nervous system, ureters, or even by the kidneys in case of nocturnal polyuria [4].…”

mentioning

confidence: 99%

Latest Developments in the Assessment and Treatment of Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia: What is Clinically Relevant?

Oelke

2015

Clin Drug Investig

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Lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) are prevalent and increase with aging. Epidemiological studies have shown that approximately 40 % of men aged C50 years have bothersome LUTS/BPH [1]. It is therefore not surprising that LUTS/BPH are positioned at 7th place in the most frequently diagnosed and most costly diseases in men aged C50 years [2]. Healthcare-seeking behavior is triggered by LUTS severity and LUTS phenotypes. Men often consult their doctors when they have severe LUTS or experience urinary urgency or nocturia [1,3]. LUTS/BPH have a multifactorial etiology and can be caused by the prostate, bladder, urethra, pelvic floor, central or peripheral nervous system, ureters, or even by the kidneys in case of nocturnal polyuria [4]. LUTS can be divided into storage (e.g., urgency, frequency, nocturia), voiding (e.g., hesitancy, poor stream, intermittency), and post-micturition symptoms (post-void dribbling, feeling of incomplete bladder emptying) [5].The majority of guidelines on LUTS/BPH have been established by urologists [4,6,7] but can also be-more or less easily-implemented by other medical specialties. Different healthcare systems worldwide have different regulations and defined responsibilities regarding which medical specialty should primarily assess and treat men with LUTS/BPH. While almost three-quarters of men with LUTS/BPH in Germany are diagnosed and treated by urologists [8], the majority of men in other countries, for example Australia or the UK, are managed by primary-care physicians. Specialized training programs and experience with patients with LUTS/BPH are therefore mandatory for different medical specialties.Careful assessment helps to identify the underlying pathophysiology of LUTS. Simple patient history or a symptom questionnaire cannot distinguish between LUTS of benign or malignant origin because the type of symptom or symptom severity is nonspecific for the underlying disease. This may limit the widespread assessment and treatment of LUTS by non-urologic professionals because special assessment tools-before treatment initiation-are usually not available in the offices of primary-care physicians (e.g., uroflowmeter, transrectal ultrasound, multichannel urodynamics, urethrocystoscopy). It is therefore crucial to know when nonurologists should transfer their patients to specialized urology care. An expert panel recommended specialized urology support in particular when physicians are in doubt of the origin or benign character of LUTS, in cases of macroscopic hematuria, or in men with absolute indications for prostate surgery [9].Adherence to guidelines is crucial for every medical specialty dealing with LUTS/BPH because real-life practice in the USA has shown that doctors who follow guidelines perform significantly less prostate surgery than doctors who do not [10]. Doctors with poor adherence to guidelines will have performed prostate surgery within the first year of diagnosis in 11 % of patients, whereas doctors with good adherence to guide...

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The International Continence Society (ICS) report on the terminology for adult male lower urinary tract and pelvic floor symptoms and dysfunction

D’Ancona

Haylen

Oelke

et al. 2019

Neurourology and Urodynamics

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Introduction In the development of terminology of the lower urinary tract, due to its increasing complexity, the terminology for male lower urinary tract and pelvic floor symptoms and dysfunction needs to be updated using a male‐specific approach and via a clinically‐based consensus report. Methods This report combines the input of members of the Standardisation Committee of the International Continence Society (ICS) in a Working Group with recognized experts in the field, assisted by many external referees. Appropriate core clinical categories and a subclassification were developed to give a numeric coding to each definition. An extensive process of 22 rounds of internal and external review was developed to exhaustively examine each definition, with decision‐making by collective opinion (consensus). Results A Terminology Report for male lower urinary tract and pelvic floor symptoms and dysfunction, encompassing around 390 separate definitions/descriptors, has been developed. It is clinically‐based with the most common diagnoses defined. Clarity and user‐friendliness have been key aims to make it interpretable by practitioners and trainees in all the different specialty groups involved in male lower urinary tract and pelvic floor dysfunction. Male‐specific imaging (ultrasound, radiology, CT, and MRI) has been a major addition whilst appropriate figures have been included to supplement and help clarify the text. Conclusions A consensus‐based Terminology Report for male lower urinary tract and pelvic floor symptoms and dysfunction has been produced aimed at being a significant aid to clinical practice and a stimulus for research.

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Nocturia and its impact on health-related quality of life and health care seeking behaviour in German community-dwelling men aged 50 years or older

Abstract: Our study confirmed that nocturnal voiding is highly prevalent in community-dwelling men and reduce both physical and mental health status. Bother from nocturnal voiding is the most relevant component of LUTS responsible for medical consultations in German men.

Cited by 34 publications

References 23 publications

Nocturia: state of the art and critical analysis of current assessment and treatment strategies

Nocturia: state of the art and critical analysis of current assessment and treatment strategies

Latest Developments in the Assessment and Treatment of Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia: What is Clinically Relevant?

The International Continence Society (ICS) report on the terminology for adult male lower urinary tract and pelvic floor symptoms and dysfunction

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