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Karamaria S, Dhondt K, Everaert K, Mauel R, Nørgaard JP, Raes A, Van Herzeele C, Verbakel I, Walle JV. First uninterrupted sleep period in children and adolescents with nocturnal enuresis: Added value in diagnosis and follow-up during therapy. Neurourol Urodyn 2024; 43:1147-1154. [PMID: 37929315 DOI: 10.1002/nau.25322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 10/22/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND The first uninterrupted sleep period (FUSP, time up to the first episode of enuresis/nocturia after falling asleep) is a frequently investigated parameter in adults with nocturia, as it correlates with quality of life. However, it has not been included in pediatric enuresis studies. AIM Investigate FUSP, circadian renal water and sodium handling, as well as sleep quality before and after desmopressin therapy in enuresis. MATERIALS AND METHODS We conducted a post hoc analysis of a prospective study in 30 treatment-naïve children with enuresis who underwent a video-polysomnography and a 24-h urine concentration profile before and after 6 months of desmopressin therapy. We analyzed FUSP, periodic limb movements in sleep (PLMS), and arousal indexes and their correlations with the urinary parameters. RESULTS Sixteen children with a mean age of 10.9 ± 3.1 years had full registrations and were included in this subanalysis. After therapy, FUSP was significantly longer (p < 0.001), and the PLMS index was lower (p = 0.023). Significant differences in the circadian rhythm of diuresis (night/day diuresis, p = 0.041), nocturnal urinary osmolality (p = 0.009), and creatinine (p = 0.001) were found, demonstrating the increase of urinary concentration overnight by desmopressin, as well as a significant antidiuretic effect (diuresis [p = 0.013] and diuresis rate (p = 0.008). There was no correlation between the difference of FUSP, PLMS index, and urinary parameters. Nevertheless, despite this study being underpowered, there are indications of a correlation between nocturnal diuresis and diuresis rate. RESULTS Our results support the need for further research regarding FUSP in children with enuresis, in accordance with nocturia studies in adults, as this parameter could be valuable in the follow-up and evaluation of therapeutic strategies for enuresis.
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Affiliation(s)
- Sevasti Karamaria
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Karlien Dhondt
- Department of Child and Adolescent Psychiatry, Pediatric Sleep Center, Ghent University Hospital, Ghent, Belgium
| | - Karel Everaert
- Department of Urology, Ghent University Hospital, Ghent, Belgium
| | - Reiner Mauel
- Department of Pediatric Intensive Care, Brussels University Hospital, Brussels, Belgium
| | | | - Ann Raes
- Department of Pediatric Nephrology, Ghent University Hospital, Ghent, Belgium
| | | | - Irina Verbakel
- Department of Urology, Ghent University Hospital, Ghent, Belgium
| | - Johan Vande Walle
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
- Department of Pediatric Nephrology, Ghent University Hospital, Ghent, Belgium
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2
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Junming C, Yin X, Liheng W, Xiangxin K, Yuan Z, Yixing R. Relief of Nocturia After Sleeve Gastrectomy in Women with Obesity. J Gastrointest Surg 2023:10.1007/s11605-023-05622-y. [PMID: 36814013 DOI: 10.1007/s11605-023-05622-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 02/06/2023] [Indexed: 02/24/2023]
Affiliation(s)
- Cheng Junming
- Department of General Surgery, and Institute of Hepato-Biliary-Pancreas and Intestinal Disease, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, People's Republic of China
| | - Xian Yin
- Department of General Surgery, and Institute of Hepato-Biliary-Pancreas and Intestinal Disease, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, People's Republic of China
- Nanchong Psychosomatic Hospital, Nanchong, 637000, People's Republic of China
| | - Wang Liheng
- Department of Infectious Diseases, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, People's Republic of China
| | - Kong Xiangxin
- Department of General Surgery, and Institute of Hepato-Biliary-Pancreas and Intestinal Disease, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, People's Republic of China
| | - Zhang Yuan
- Department of General Surgery, and Institute of Hepato-Biliary-Pancreas and Intestinal Disease, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, People's Republic of China
| | - Ren Yixing
- Department of General Surgery, and Institute of Hepato-Biliary-Pancreas and Intestinal Disease, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, People's Republic of China.
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Yoon JH, Lee K, Park EJ, Kwon T, Park S, Moon KH, Kim SC. Analysis of changes in the pathophysiology of nocturia according to the number of nocturia episode, age, and gender using frequency volume charts: A retrospective observational study. Medicine (Baltimore) 2022; 101:e31295. [PMID: 36316868 PMCID: PMC9622670 DOI: 10.1097/md.0000000000031295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To evaluate the pathophysiology of nocturia based on the frequency volume chart, and determine the risk factors for nocturia occurring ≥2 times per night. MATERIALS AND METHODS In this retrospective study, we reviewed 311 patients with complaints of nocturia from January 2017 to February 2019 at our institution. Nocturnal polyuria (NP) and global polyuria (GP) were defined as NP index >0.35 regardless of age and 24 h urine volume >2.5 L/day, respectively. Decreased bladder capacity (dBC) was when the maximal voided volume was <325 mL. Decreased nocturnal bladder capacity (dNBC) was defined as nocturnal bladder capacity index >0. RESULTS In total, 273 patients were included in the primary analyses. Of 802 days from 273 frequency volume charts, the median number of nocturia was 1 episode per day. Further, NP (odds ratios [OR] 7.01), GP (OR 4.25), dBC (OR 3.00), dNBC (OR 10.12), and age (OR 1.04) had the association with nocturia ≥2 times per night. There was a significant stepwise increase in NP, dNBC, dBC, and GP with the number of nocturia episodes. As patient age increased, the likelihood of NP (P < 0.001) and dBC (P < 0.001) being the cause for nocturia tended to increase, but that of dNBC (P = 0.022) and nocturia without cause (P = 0.007) tended to decrease. Moreover, dBC was more likely to cause nocturia in female patients than in male patients (P < 0.001). CONCLUSION NP, dBC, dNBC, and GP are important factors involved in the pathophysiology of nocturia occurring ≥2 times per night.
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Affiliation(s)
- Ji Hyung Yoon
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Kisoo Lee
- Department of Urology, Dong-A University Hospital, Busan, Korea
| | - Eun Ji Park
- BigData Center, Ulsan University Hospital, Ulsan, Korea
| | - Taekmin Kwon
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Sungchan Park
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Kyung Hyun Moon
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Seong Cheol Kim
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
- * Correspondence: Seong Cheol Kim, Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwando-ro, Dong-gu, Ulsan 44033, Rep. of Korea (e-mail: )
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4
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Bower WF, Rose GE, Whishaw DM, Ervin CF, Wang AC, Moore KH. The association between nocturia, hormonal symptoms and bladder parameters in women: an observational study. BJOG 2022; 129:812-819. [PMID: 34028168 DOI: 10.1111/1471-0528.16752] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Postmenopausal nocturia is poorly understood. This study aimed to identify hormonal and lifestyle factors associated with nocturia and to understand the relative contribution of altered urine production and bladder storage dysfunction in women. DESIGN, SETTING, POPULATION AND METHODS Women ≥40 years presenting to public continence services were enrolled in a cross-sectional study. A total of 153 participants completed a hormone status questionnaire, a validated nocturia causality screening tool and a 3-day bladder diary. Descriptive statistics and logistic regression models for nocturia severity and bladder diary parameters were computed. RESULTS Overall, 91.5% reported nocturia, 55% ≥2 /night. There was a difference of 167.5 ml (P < 0.001) in nocturnal urine volume between women with nocturia ≥2 (median 736 ml) versus less often (517 ml). Significant predictors of self-reported disruptive nocturia were age (odds ratio [OR] 1.04, 95% CI 1.002-1.073) and vitamin D supplementation (OR 2.33, 95% CI 1.11-4.91). Nocturnal polyuria was significantly more common with nocturia ≥2 compared with less frequent nocturia (P < 0.002). Exercise for 150 minutes a week was protective for nocturnal polyuria (OR 0.22, P = 0.001). Nocturia index >1.3 was significantly predicted by age (OR 1.07, P < 0.001), regular exercise (OR 0.41, P = 0.036), day flushes (OR 4.00, P = 0.013) and use of vitamin D (OR 2.34, P = 0.043). Maximum voided volumes were significantly lower with nocturia ≥2 versus less often (night: 268 ml versus 350 ml; day: 200 ml versus 290 ml). CONCLUSIONS Bothersome nocturia in postmenopausal women is associated with changes to both nocturnal diuresis and bladder storage. Regular physical activity, prolapse reduction and oestrogen replacement may be adjunctive in managing bothersome nocturia in women.
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Affiliation(s)
- W F Bower
- Department of Medicine & Aged Care, The Royal Melbourne Hospital, Parkville, VIC, Australia
- Department of Sub-Acute Care Services, The Royal Melbourne Hospital, Parkville, VIC, Australia
- Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - G E Rose
- Department of Medicine & Aged Care, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - D M Whishaw
- Department of Medicine & Aged Care, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - C F Ervin
- Department of Sub-Acute Care Services, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - A C Wang
- Department of Urology, Westmead Hospital, University of Sydney, Sydney, NSW, Australia
| | - K H Moore
- Department of Urogynaecology, St George Hospital, University of New South Wales, Sydney, NSW, Australia
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Harris WN, Everaert K. Overactive Bladder as a Key Driver of Nocturia: The Argument Against. Eur Urol Focus 2022; 8:6-7. [PMID: 35027328 DOI: 10.1016/j.euf.2021.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/17/2021] [Accepted: 12/28/2021] [Indexed: 11/26/2022]
Abstract
Studies have shown that therapies for overactive bladder reduce urgency symptoms. However, these studies fail to demonstrate clinically significant increases in bladder capacity or changes in mean voided volumes at night.
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Affiliation(s)
- William N Harris
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.
| | - Karel Everaert
- Department of Urology, Ghent University Hospital, Ghent, Belgium
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Miller CD, Monaghan TF, Robins DJ, Weiss JP. Does traditional pharmacotherapy augment behavioral modification in the treatment of nocturia? Neurourol Urodyn 2021; 40:1133-1139. [PMID: 33973671 DOI: 10.1002/nau.24692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/31/2021] [Accepted: 04/15/2021] [Indexed: 11/07/2022]
Abstract
AIMS To assess the efficacy of traditional first-line non-antidiuretic pharmacotherapy for nocturia in the real-world outpatient urology setting. METHODS We retrospectively analyzed voiding diaries from adult men treated for lower urinary tract symptoms (LUTS) at an outpatient urology clinic to identify pairs of voiding diaries with ≥1 nocturnal void at baseline and a corresponding follow-up diary completed within 1 year. We compared the odds of nocturia improvement (decrease of ≥1 nocturnal void) in patients started on LUTS pharmacotherapy versus behavioral modification alone. RESULTS Two hundred and thirteen diary pairs from 93 patients were included. Fifty-seven diary pairs were identified from patients prescribed at least one LUTS drug on the initial visit and 156 diary pairs were identified from patients receiving behavioral modification alone. All standard voiding diary parameters were assessed, and only maximum voided volume differed at baseline (240 ml [interquartile range: 200-330 ml] vs. 280 ml [200-400 ml] with and without pharmacotherapy, respectively, p = 0.04). The odds of nocturia improvement did not significantly differ between pharmacotherapy and behavioral modification treatment groups (crude odds ratio [OR]: 1.16 [95% confidence interval: 0.63-2.16], p = 0.63; maximum voided volume [MVV]-adjusted OR: 1.19 [0.63-2.22], p = 0.59). In contrast, improvement in 24-h urinary frequency was more likely with pharmacotherapy versus behavioral modification alone (crude OR: 2.36 [1.22-4.56], p = 0.01; MVV-adjusted OR: 2.05 [1.05-4.01], p = 0.04). Results were consistent on subgroup analyses restricted to first diary pairs from each patient. CONCLUSION Despite improvement in 24-h voiding frequency, there was no evidence that adjunctive pharmacotherapy provided a benefit in the treatment of nocturia in men receiving behavioral counseling.
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Affiliation(s)
- Connelly D Miller
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA.,Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York, USA
| | - Thomas F Monaghan
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA.,Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York, USA
| | - Dennis J Robins
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA.,Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York, USA
| | - Jeffrey P Weiss
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA.,Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York, USA
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Monaghan TF, Khargi R, Miller CD, Agudelo CW, Bruha MJ, Fink LE, Lazar JM, Everaert K, Weiss JP. The modified nocturia index: Refining the workup for nocturia. Neurourol Urodyn 2020; 40:555-557. [PMID: 33053219 DOI: 10.1002/nau.24545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/20/2020] [Accepted: 10/06/2020] [Indexed: 11/06/2022]
Affiliation(s)
- Thomas F Monaghan
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Raymond Khargi
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Connelly D Miller
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Christina W Agudelo
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Matthew J Bruha
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Lauren E Fink
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Jason M Lazar
- Department of Medicine, Division of Cardiovascular Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Karel Everaert
- Department of Urology, Ghent University Hospital, Ghent, Belgium
| | - Jeffrey P Weiss
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
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Elhadi M, Younis A, Harding C. A systematic approach to the investigation and treatment of nocturia. JOURNAL OF CLINICAL UROLOGY 2020. [DOI: 10.1177/2051415818781289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Level of evidence: 4.
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Monaghan TF, Rahman SN, Bliwise DL, Michelson KP, Agudelo CW, Miller CD, Weinstein CS, Olesen TK, Lazar JM, Everaert K, Verbalis JG, Weiss JP. Identifying men with global polyuria on a nocturnal-only voiding diary. Neurourol Urodyn 2019; 39:347-352. [PMID: 31692071 DOI: 10.1002/nau.24210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 10/20/2019] [Indexed: 11/05/2022]
Abstract
AIMS Nocturnal polyuria (NP) and global polyuria (GP) are not mutually exclusive. However, by rate, the common criteria for GP (40 mL/kg/24 hours [117 mL/kg/hour in a 70-kg individual] or 3000 mL/24 hours [125 mL/h]) are more stringent than those for NP (90 mL/hour during the sleep period or NP index [NPi; nocturnal volume/24-hour volume] > 0.33 [no minimum rate]). It remains unclear whether total nocturnal urine volume (NUV) may reliably delineate between NP patients with and without comorbid GP. METHODS A clinical database of men with lower urinary tract symptoms was searched for voiding diaries completed by patients reporting greater than or equal to 1 nocturnal void(s). Four separate analyses were performed using all combinations of the two NP and two GP criteria listed above. For each analysis, patients were included if they met the criteria for NP, and then stratified by presence or absence of GP (ie, NP + GP vs isolated NP). RESULTS Median NUV was greater among patients with NP + GP for all criteria combinations. Sensitivities greater than or equal to 80%/90%/100% for NP + GP were observed at 1275/1230/1085 mL for {NPi > 0.33 + 24-hour volume > 3000 mL}; 1075/1035/1035 mL for {NPi > 0.33 + 24-hour volume > 40 mL/kg}; 900/745/630 mL for {NUP > 90 mL/hour + 24-hour volume > 3000 mL}; and 1074/1035/990 mL for {NUP > 90 mL/hour + 24-hour volume > 40 mL/kg}. CONCLUSIONS An inordinate NUV among men with NP is fairly sensitive for comorbid GP. In the appropriate clinical setting, nocturnal-only diaries may suffice in the evaluation and follow-up of patients with NP, so long as outlying nocturnal volumes prompt a 24-hour diary/urine collection.
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Affiliation(s)
- Thomas F Monaghan
- Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, New York
| | - Syed N Rahman
- Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, New York
| | - Donald L Bliwise
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
| | - Kyle P Michelson
- Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, New York
| | - Christina W Agudelo
- Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, New York
| | - Connelly D Miller
- Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, New York
| | - Corey S Weinstein
- Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, New York
| | - Tine K Olesen
- Department of Urogynaecology, Ghent University Hospital, Ghent, Belgium
| | - Jason M Lazar
- Department of Medicine, Division of Cardiovascular Medicine, State University of New York Downstate Health Sciences University, Brooklyn, New York
| | - Karel Everaert
- Department of Urology, Ghent University Hospital, Ghent, Belgium
| | - Joseph G Verbalis
- Department of Medicine, Division of Endocrinology and Metabolism, Georgetown University Medical Center, Washington, District of Columbia
| | - Jeffrey P Weiss
- Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, New York
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Weiss JP, Everaert K. Management of Nocturia and Nocturnal Polyuria. Urology 2019; 133S:24-33. [DOI: 10.1016/j.urology.2019.09.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 09/13/2019] [Accepted: 09/20/2019] [Indexed: 01/15/2023]
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Weiss JP, Monaghan TF, Epstein MR, Lazar JM. Future Considerations in Nocturia and Nocturnal Polyuria. Urology 2019; 133S:34-42. [PMID: 31233816 DOI: 10.1016/j.urology.2019.06.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 05/22/2019] [Accepted: 06/11/2019] [Indexed: 12/13/2022]
Abstract
Nocturnal polyuria (NP), the most common etiology of nocturia, can be caused by various medical conditions, including cardiovascular disease, obstructive sleep apnea, renal tubular dysfunction, as well as medications (eg, diuretics) and/or behavioral patterns. NP in the absence of underlying medical conditions has been described as NP syndrome and is thought be the result of impaired circadian release of endogenous arginine vasopressin. Desmopressin, a synthetic arginine vasopressin analog, has been shown to be an effective replacement therapy in adults with nocturia due to NP. Further studies on the subset of patients with NP syndrome are warranted to maximize benefit from antidiuretic treatment. In addition, a connection between the pathophysiological mechanisms underlying NP and essential hypertension has been suggested, and hypertension has been shown to be a significant risk factor for nocturia, while an association between NP and brain natriuretic peptide levels has also been reported in patients with nocturia. Hypertension is now viewed as a disorder of blood vessels and treatment is directed at the vasculature rather than the blood pressure, with the latter currently serving as a biomarker for arterial injury. Nocturia is thought to be associated with the beginning of this cardiovascular continuum as studies have reported a link between coronary heart disease and nocturia. Therefore, there is an increasing need to elucidate the complex mechanisms implicated in the association between nocturia and hypertension to promote the development of more individualized therapies for the treatment of nocturia.
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Affiliation(s)
- Jeffrey P Weiss
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY.
| | - Thomas F Monaghan
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY
| | - Matthew R Epstein
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY
| | - Jason M Lazar
- Department of Medicine, Division of Cardiovascular Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY
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Epstein MR, Monaghan T, Weiss JP. Etiology of nocturia response in men with diminished bladder capacity. Neurourol Urodyn 2018; 38:215-222. [DOI: 10.1002/nau.23832] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 09/08/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Matthew R. Epstein
- Department of Urology; SUNY Downstate College of Medicine; Brooklyn New York
| | - Thomas Monaghan
- Department of Urology; SUNY Downstate College of Medicine; Brooklyn New York
| | - Jeffrey P. Weiss
- Department of Urology; SUNY Downstate College of Medicine; Brooklyn New York
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13
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Abstract
Purpose of Review To assess current pharmacological principles used for treatment of nocturia/nocturnal polyuria. Recent Findings The pathophysiology of nocturia is often multifactorial, but two main mechanisms have been identified, occurring alone or in combination: low functional bladder capacity and nocturnal polyuria. The multifactorial pathophysiology not only implies several possible targets for therapeutic intervention but also means that it is unlikely that one treatment modality including drugs will be successful in all patients. Drugs approved for the treatment of male LUTS and male and female OAB are known to be far more effective for treatment of the daytime symptoms than for nocturia. Summary Several pharmacological principles have been tested with varying success. The treatment of choice should depend upon the main underlying cause, thus aiming primarily to increase bladder capacity by counteracting detrusor overactivity and/or reducing nocturnal polyuria. Using current available agents, effective, personalized treatment should be designed taking into account gender, co-morbidities, and identified etiological factors. However, there is a medical need for new, approved drugs for treatments for patients with nocturia.
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Affiliation(s)
- Karl-Erik Andersson
- Lund University, Lund, Sweden. .,Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston Salem, NC, USA. .,Institute of Clinical Medicine, Department of Obstetrics and Gynecology, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, DK, Denmark.
| | - Philip Van Kerrebroeck
- Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands
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