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

Oelke, Matthias; Adler, Erika; Marschall-Kehrel, Daniela; Herrmann, Thomas; Berges, Richard

doi:10.1007/s00345-014-1396-0

Cited by 41 publications

(50 citation statements)

References 32 publications

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“…Several patterns of NOC exist such as a reduced bladder capacity and nocturnal polyuria, and these are caused by many types of diseases . The key drugs for the treatment of NOC/NP have been α 1 ‐blockers for benign prostatic hyperplasia and anti‐cholinergic drugs or β 3 ‐agonists for an overactive bladder, and desmopressin for NP.…”

Section: Discussionmentioning

confidence: 99%

“…The key drugs for the treatment of NOC/NP have been α 1 ‐blockers for benign prostatic hyperplasia and anti‐cholinergic drugs or β 3 ‐agonists for an overactive bladder, and desmopressin for NP. Furthermore, palliative treatments depending on the cause, such as anti‐hypertensive drugs and diuretic medications for high blood pressure patients, are provided in clinical settings . However, a large number of patients are refractory to these treatments, and further developments are needed in order to discover new unknown causes of and treatments for NOC/NP.…”

Section: Discussionmentioning

confidence: 99%

“…). The Nocturnal Polyuria Index (NPI) was calculated following the definition in humans, by dividing nocturnal urine volume by the 24 hr urine volume …”

Section: Methodsmentioning

confidence: 99%

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The Clock mutant mouse is a novel experimental model for nocturia and nocturnal polyuria

Ihara

Mitsui

Nakamura

et al. 2016

Neurourology and Urodynamics

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Clock mutant mouse is a novel experimental model for nocturia and nocturnal polyuria

Ihara

Mitsui

Nakamura

et al. 2016

Neurourology and Urodynamics

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“…With the prevalence of NOC, it raise the various risk such as sleeping disorder, mental health, bone fracture by fall and reduce the life span [4–7]. Many diseases cause NOC, and the palliative treatments depending on the causes, such as α 1 -blockers for benign prostatic hyperplasia, anti-cholinergic drugs or β 3 -agonists for an overactive bladder, desmopressin for nocturnal polyuria, anti-hypertensive drugs and diuretic medications for high blood pressure patients, are provided in clinical settings [8]. However, because the pathophysiologies of NOC are multifactorial and remain unclear in a large number of patients, these treatments are often not so effective and become refractory.…”

Section: Introductionmentioning

confidence: 99%

Clock Genes Regulate the Circadian Expression of Piezo1, TRPV4, Connexin26, and VNUT in an Ex Vivo Mouse Bladder Mucosa

et al. 2017

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ObjectivesClockΔ19/Δ19 mice is an experimental model mouse for nocturia (NOC). Using the bladder mucosa obtained from ClockΔ19/Δ19 mice, we investigated the gene expression rhythms of mechanosensory cation channels such as transient receptor potential cation channel subfamily V member 4 (TRPV4) and Piezo1, and main ATP release pathways including vesicular nucleotide transporter (VNUT) and Connexin26(Cx26), in addition to clock genes.Materials and methodsEight- to twelve-week-old male C57BL/6 mice (WT) and age- and sex-matched C57BL/6 ClockΔ19/Δ19 mice, which were bred under 12-h light/dark conditions for 2 weeks, were used. Gene expression rhythms and transcriptional regulation mechanisms in clock genes, mechanosensor, Cx26 and VNUT were measured in the mouse bladder mucosa, collected every 4 hours from WT and ClockΔ19/Δ19 mice using quantitative RT-PCR, a Western blot analysis, and ChIP assays.ResultsWT mice showed circadian rhythms in clock genes as well as mechanosensor, Cx26 and VNUT. Their expression was low during the sleep phase. The results of ChIP assays showed Clock protein binding to the promotor regions and the transcriptional regulation of mechanosensor, Cx26 and VNUT. In contrast, all of these circadian expressions were disrupted in ClockΔ19/Δ19 mice. The gene expression of mechanosensor, Cx26 and VNUT was maintained at a higher level in spite of the sleep phase.ConclusionsMechanosensor, Cx26 and VNUT expressed with circadian rhythm in the mouse bladder mucosa. The disruption of circadian rhythms in these genes, induced by the abnormalities in clock genes, may be factors contributing to NOC because of hypersensitivity to bladder wall extension.

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“…This leads to the questions why so few physicians used bladder diaries and, when a bladder diary was used, why the physicians did not transfer the diary results to meaningful, pathophysiology‐based treatments, especially considering that bladder diaries are recommended by several expert groups and guideline panels in case patients report about nocturia or bladder storage symptoms . A bladder diary for 2–7 days is the diagnostic tool of first choice to detect the underlying pathophysiology of nocturia, where global polyuria (24‐hour urine volume >40 mL/kg body weight), nocturnal polyuria (nocturnal urine volume >33% of the 24‐hour urine volume) or reduced maximum voided volume (urinary frequency due to reduced anatomical or functional bladder capacity) can be discriminated . The results of bladder diaries can be used to initiate treatment based on the pathophysiology of LUTS.…”

Section: Discussionmentioning

confidence: 99%

Nocturia is often inadequately assessed, diagnosed and treated by physicians: results of an observational, real‐life practice database containing 8659 European and US ‐American patients

et al. 2016

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SummaryAimsThe aim of this study was to investigate the quality and timing of the diagnosis and treatment of nocturia in real‐life practice in European and US‐American patients to obtain better insights into the management of nocturia in different Western healthcare systems.MethodsData were drawn from the “LUTS Disease Specific Programme,” a real‐life survey of physicians and patients in France, Germany, Spain, UK and the USA. Physicians completed a patient record form for lower urinary tract symptoms (LUTS) patients. Patients filled out a self‐completion form, indicating – among other items – information on the mean number of day‐ and night‐time voids during the last 7 days, and questions on the management of LUTS in daily practice.ResultsIn total, 8659 patients were analysed. The majority of patients initially consulted a physician because of worsening of LUTS frequency (43%–58%) or severity (44%–55%). Only 37% of all LUTS diagnoses, regardless of the appearance or severity of nocturia, were based on bladder diaries. Patients took approximately 1 year to consult a medical professional following the onset of LUTS. At the initial visit, most patients received advice on behavioural strategies. Regardless the type of LUTS and physician, 59% of men received α‐blockers and 76% of women antimuscarinics.ConclusionsData show that patients with nocturia and LUTS accept their symptoms for a considerable period before they seek help or ultimately receive treatment. They may therefore be enduring significant negative impact on their quality‐of‐life which could be avoided. Physicians rarely use bladder diaries and primarily use antimuscarinics (women) or α‐blockers (men). Improved awareness of nocturia among patients and physicians could improve the management of nocturia.

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

Cited by 41 publications

References 32 publications

The Clock mutant mouse is a novel experimental model for nocturia and nocturnal polyuria

The Clock mutant mouse is a novel experimental model for nocturia and nocturnal polyuria

Clock Genes Regulate the Circadian Expression of Piezo1, TRPV4, Connexin26, and VNUT in an Ex Vivo Mouse Bladder Mucosa

Nocturia is often inadequately assessed, diagnosed and treated by physicians: results of an observational, real‐life practice database containing 8659 European and US ‐American patients

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