Urodynamic findings in patients with nocturia and their associations with patient characteristics

Abstract

Introduction: This study identified associations between lower urinary tract pathology confirmed on urodynamic testing, baseline characteristics, and symptoms for adults with nocturia. Nocturia frequency was examined for predictors. Methods: This retrospective study from 2012–2019 analyzed adult patients referred for urodynamic testing, with nocturia (waking to void ≥2x/night). Data on baseline characteristics, symptoms, urodynamic parameters, and lower urinary tract pathology were recorded. Males and females were analyzed separately, and univariable analyses were conducted, stratified by lower urinary tract pathology. Multivariable regression models were fit. Nocturia frequency was analyzed for associations with clinical parameters. Results: Altogether, 372 patients were included (159 men and 213 women). More men had detrusor overactivity (DO) (p<0.001) and bladder outlet obstruction (BOO) (p<0.001). DO was associated with storage symptoms (odds ratio [OR] 5.19, p<0.001), in addition to older age (p=0.009) and being male (p<0.001). Detrusor underactivity (DU) was associated with voiding symptoms (OR 1.92, p=0.004), older age (p<0.001), and being female (p=0.018). BOO was associated voiding symptoms (OR 2.09, p=0.023), younger age (p=0.018), and being male (p<0.001). The quantity of lower urinary tract symptoms was associated with DU and DO. Nocturia frequency was not associated with baseline variables or underlying pathologies. A substantial number of patients were diagnosed with DU alone (n=69, 18.7%) or associated with other diagnoses (n=108, 29.3%). Conclusions: Careful assessment of risk factors and symptoms may help identify underlying lower urinary tract pathology for adults with nocturia. DU is found in a significant proportion of patients with nocturia, a previously under-reported result.

Prevalência de noctúria e fatores associados em mulheres atendidas em dois ambulatórios de uroginecologia no estado do Rio de Janeiro: um estudo transversal

“…Além disso, é frequente a coexistência de SBH e outros STUI. Chan et al 24 avaliaram estudos urodinâmicos realizados em 213 mulheres com queixa de noctúria e identificaram, em 28% dos casos, a presença concomitante de hiperatividade detrusora, que pode estar presente na SBH, e de hipoatividade detrusora, condição que pode reduzir a capacidade vesical devido a um resíduo pós-miccional elevado.…”

Prevalence and relevant factors of nocturia and its impact on sleep quality in Chinese university students

“…Causes of nocturia included urologic and non-urologic factors. Urologic causes of nocturia might include reduced bladder capacity, nocturnal polyuria, detrusor overactivity and mixed aetiology [27][28][29] . Non-urologic causes of nocturia also included different factors, such as higher BMI, smoking, drinking, hypertension and diabetes mellitus 30,31 .…”

Prevalence of nocturia and associated factors in women attending two urogynecology outpatient clinics in the state of Rio de Janeiro: a cross-sectional study

“…Additionally, the coexistence of OAB syndrome and other LUTS is common. Chan et al 24 evaluated urodynamic studies conducted on 213 women with complaints of nocturia and identified, in 28% of cases, the simultaneous presence of detrusor overactivity, which may be present in OAB syndrome, and detrusor underactivity, a condition that can reduce bladder capacity due to elevated post-void residual.…”