Skip to main content

Advertisement

Log in

Nocturia

  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

This article reviews the state of knowledge and the algorithms for the diagnosis, classification, and treatment of nocturia. The state of the art in diagnosis, classification, and treatment of nocturia is presented. Nocturia has been poorly classified and poorly understood. Multiple factors may result in nocturia, among which are pathologic conditions such as cardiovascular disease, diabetes mellitus, lower urinary tract obstruction, anxiety or primary sleep disorders, and behavioral and environmental factors. Nocturia may be attributed to nocturnal polyuria (nocturnal urine overproduction), diminished nocturnal bladder capacity, or a combination of the two. Distinction between these conditions is made by a simple arithmetic analysis of the 24-hour voiding diary. Nocturia has been poorly studied and, only recently, has been classified according to its etiology and pathogenesis. Based on a review of the current state of knowledge, this article presents a scheme for the classification and treatment of patients suffering from loss of sleep resulting from nocturnal micturition.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Van Kerrebroeck P, Weiss J: Standardization and terminology of Nocturia. BJU Int 1999, 84(suppl 1):1–4. This paper set forth proposed standards for terminology designed to classify and quantify various etiologies of nocturia.

    Article  PubMed  Google Scholar 

  2. Umlauf MG, Goode S, Burgio KL: Psychosocial issues in geriatric urology: problems, treatment, and treatment seeking. Urol Clin North Am 1996, 23:127–136.

    Article  PubMed  CAS  Google Scholar 

  3. Abrams P, Blaivas JG, Stanton S, et al.: The standardization of terminology of lower urinary tract function. International Continence Society Committee on Standardization of Terminology. Scand J Urol Nephrol Suppl 1988, 114:5–19.

    PubMed  CAS  Google Scholar 

  4. Blaivas JG, Stember DS, Weiss JP: Etiology of voiding symptoms in men: correlation of individual AUA symptom scores with urodynamic and diary parameters. Neurourol Urodyn 1998, 17:398–399.

    Google Scholar 

  5. Asplund R: The nocturnal polyuria syndrome (NPS). Gen Pharmacol 1995, 26:1203–1209. Seminal description of nocturnal urine overproduction as a major cause for nocturia.

    PubMed  CAS  Google Scholar 

  6. Matthiesen TB, Rittig S, Norgaard JP, et al.: Nocturnal polyuria and natriuresis in male patients with nocturia and lower urinary tract symptoms. J Urol 1996, 156:1292–1299.

    Article  PubMed  CAS  Google Scholar 

  7. Rembratt A, Weiss J, Robertson G: Pathogenesis of nocturia in the elderly: relationship of functional bladder capacity to nocturnal urine output. J Urol 2001, 165(suppl):250.

    Google Scholar 

  8. Ozawa T, Oyanagi K, Tanaka H, et al.: Suprachiasmatic nucleus in a patient with multiple system atrophy with abnormal circadian rhythm of arginine-vasopressin secretion into plasma. J Neurol Sci 1998, 154:116–121.

    Article  PubMed  CAS  Google Scholar 

  9. KirklandJ L, Lye M, Levy DW, Banerjee AK: Patterns of urine flow and electrolyte excretion in healthy elderly people. Br Med J 1983, 287:1665–1667.

    Google Scholar 

  10. Baylis PH: Osmoregulation and control of vasopressin secretion in healthy humans. Am J Physiol 1987, 235:R671-R678.

    Google Scholar 

  11. Asplund R, Aberg H: Diurnal variation in the levels of antidiuretic hormone in elderly subjects with nocturia. J Intern Med 1991, 229:131–134.

    Article  PubMed  CAS  Google Scholar 

  12. Yalkut D, Lee LY, Grider J, et al.: Mechanism of atrial natriuretic peptide release with increased inspiratory resistance. J Lab Clin Med 1996, 128:322–328.

    Article  PubMed  CAS  Google Scholar 

  13. Partinen M: Epidemiology of obstructive sleep apnea syndrome. Curr Opin Pulm Med 1995, 1:482–487.

    Article  PubMed  CAS  Google Scholar 

  14. Krieger J, Petian C, Sforza E, et al.: Nocturnal pollakiuria is a symptom of obstructive sleep apnea. Urol Int 1993, 50:93–97.

    Article  PubMed  CAS  Google Scholar 

  15. Robinson AG: DDAVP in the treatment of diabetes insipidus. N Engl J Med 1976, 294:507–511.

    Article  PubMed  CAS  Google Scholar 

  16. Pedersen PA, Johansen PB: Prophylactic treatment of adult nocturia with bumetanide. Br J Urol 1988, 62:145.

    Article  PubMed  CAS  Google Scholar 

  17. Reynard JM, Cannon A, Yang Q, Abrams P: A novel therapy for nocturnal polyuria: a double-blind, randomized trial of furosemide against placebo. Br J Urol 1998, 81:215–218.

    PubMed  CAS  Google Scholar 

  18. Hunsballe J, Rittig S, Pederson E, et al.: Single-dose imipramine reduces nocturnal urine output in patients with nocturnal enuresis and nocturnal polyuria. J Urol 1997, 158:830–836.

    Article  PubMed  CAS  Google Scholar 

  19. Adam P: Evaluation and management of diabetes insipidus. Am Fam Physician 1997, 55:2146–2153.

    PubMed  CAS  Google Scholar 

  20. WeissJP, Blaivas JG: Nocturia. J Urol 2000, 163:5–12. The most comprehensive single summary of etiology, diagnosis, and treatment of nocturia.

    Article  PubMed  CAS  Google Scholar 

  21. Weiss JP, Blaivas JG: Urological Symptoms of Nonurologic Origin. American Urological Association Update Series: Lesson 17; 2002.

  22. Van Kerrebroeck P, Abrams P, Chaikin D, et al.: The standardization of terminology in nocturia: report from the Standardization Sub-Committee of the International Continence Society. Neurourol Urodyn 2002, 21:179–183.

    Article  PubMed  Google Scholar 

  23. WeissJP, Stember DS, Blaivas JG: Nocturia in adults: classification and etiology. Neurourol Urodyn 1997, 16:401. Original work documenting the use of newer nocturia indices demonstrating multifactorial etiologies of nocturia with an emphasis on the issue of nocturnal urine overproduction.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Weiss, J.P., Blaivas, J.G. Nocturia. Curr Urol Rep 4, 362–366 (2003). https://doi.org/10.1007/s11934-003-0007-1

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11934-003-0007-1

Keywords

Navigation