World Journal of Urology

, Volume 33, Issue 5, pp 677–683 | Cite as

Prevalence, risk factors, and symptom bother of nocturia: a population-based survey in China

  • Yuliang Wang
  • Hao Hu
  • Kexin XuEmail author
  • Xiaopeng Zhang
  • Xiaofeng Wang
  • Yanqun Na
  • Xiaoping Kang
Original Article



To evaluate the prevalence, risk factors, and symptom bother of nocturia in Chinese adults.


A population-based, cross-sectional survey was conducted among individuals aged ≥18 years in five geographical regions of China, via a stratified sampling approach. A structured questionnaire was used to obtain information on sociodemographic characteristics, general health, and past disease, and the International Consultation on Incontinence Questionnaire-Male/Female Lower Urinary Tract Symptoms Long Form was administered to estimate the prevalence of nocturia and rate their symptom bother. The current International Continence Society definition of nocturia (≥1 void/night) was used, and a secondary analysis was conducted with the threshold of two or more voids per night.


Of the 4,723 subjects contacted, 3,023 completed the interviews (64 % response rate). After being weighted by age and genders, 57.5 % participants reported voiding once or more per night and 24.7 % twice or more per night. Advanced age, higher body mass index, smoking, hypertension, and diabetes mellitus were associated risk factors in both genders. Lower urinary tract symptoms suggestive of benign prostatic enlargement increased the occurrence of nocturia in men, and higher parity and vaginal delivery were correlated with nocturia in women. Degree of bother increased with the higher frequency of nocturia, but was not affected by genders.


The prevalence of nocturia is quite high in China and increases with advancing age. Nocturia bothers sufferers greatly, and many known risk factors are associated with this bothersome condition. Experiencing two or more nightly voids is more clinically relevant.


Prevalence Risk factors Bother Nocturia Survey China 



This work was funded by Pfizer, Inc. under the Pfizer Asia–Pacific Urology Research Grant Program.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

This study was approved by the ethics committees of Peking University People’s Hospital, and written informed consent was obtained in all participants. Our study conforms to the provisions of the Declaration of Helsinki revised in Tokyo 2008.


  1. 1.
    Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A (2002) The standardisation of terminology of lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Neurourol Urodyn 21(2):167–178CrossRefPubMedGoogle Scholar
  2. 2.
    Kupelian V, Wei JT, O’Leary MP, Kusek JW, Litman HJ, Link CL, McKinlay JB (2006) Prevalence of lower urinary tract symptoms and effect on quality of life in a racially and ethnically diverse random sample: the Boston Area Community Health (BACH) Survey. Arch Intern Med 166(21):2381–2387CrossRefPubMedGoogle Scholar
  3. 3.
    Coyne KS, Zhou Z, Bhattacharyya SK, Thompson CL, Dhawan R, Versi E (2003) The prevalence of nocturia and its effect on health-related quality of life and sleep in a community sample in the USA. BJU Int 92(9):948–954CrossRefPubMedGoogle Scholar
  4. 4.
    Yoshimura K, Terada N, Matsui Y, Terai A, Kinukawa N, Arai Y (2004) Prevalence of and risk factors for nocturia: analysis of a health screening program. Int J Urol 11(5):282–287CrossRefPubMedGoogle Scholar
  5. 5.
    Tikkinen KA, Auvinen A, Johnson TN, Weiss JP, Keranen T, Tiitinen A, Polo O, Partinen M, Tammela TL (2009) A systematic evaluation of factors associated with nocturia—the population-based FINNO study. Am J Epidemiol 170(3):361–368CrossRefPubMedCentralPubMedGoogle Scholar
  6. 6.
    Coyne KS, Sexton CC, Thompson CL, Milsom I, Irwin D, Kopp ZS, Chapple CR, Kaplan S, Tubaro A, Aiyer LP, Wein AJ (2009) The prevalence of lower urinary tract symptoms (LUTS) in the USA, the UK and Sweden: results from the epidemiology of LUTS (EpiLUTS) study. BJU Int 104(3):352–360CrossRefPubMedGoogle Scholar
  7. 7.
    Irwin DE, Milsom I, Hunskaar S, Reilly K, Kopp Z, Herschorn S, Coyne K, Kelleher C, Hampel C, Artibani W, Abrams P (2006) Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol 50(6):1306–1314, 1314–1315Google Scholar
  8. 8.
    Tikkinen KA, Tammela TL, Huhtala H, Auvinen A (2006) Is nocturia equally common among men and women? A population based study in Finland. J Urol 175(2):596–600CrossRefPubMedGoogle Scholar
  9. 9.
    Abrams P, Avery K, Gardener N, Donovan J (2006) The International Consultation on Incontinence Modular Questionnaire: J Urol 175(3 Pt 1):1063–1066
  10. 10.
    Diokno AC, Brown MB, Goldstein NG, Herzog AR (1994) Urinary flow rates and voiding pressures in elderly men living in a community. J Urol 151(6):1550–1553PubMedGoogle Scholar
  11. 11.
    Kawauchi A, Tanaka Y, Soh J, Ukimura O, Kojima M, Miki T (2000) Causes of nocturnal urinary frequency and reasons for its increase with age in healthy older men. J Urol 163(1):81–84CrossRefPubMedGoogle Scholar
  12. 12.
    Choo MS, Ku JH, Park CH, Lee YS, Lee KS, Lee JG, Park WH (2008) Prevalence of nocturia in a Korean population aged 40 to 89 years. Neurourol Urodyn 27(1):60–64CrossRefPubMedGoogle Scholar
  13. 13.
    Bosch JL, Weiss JP (2013) The prevalence and causes of nocturia. J Urol 189(1 Suppl):S86–S92CrossRefPubMedGoogle Scholar
  14. 14.
    Madersbacher S, Pycha A, Schatzl G, Mian C, Klingler CH, Marberger M (1998) The aging lower urinary tract: a comparative urodynamic study of men and women. Urology 51(2):206–212CrossRefPubMedGoogle Scholar
  15. 15.
    Yoshimura K, Kamoto T, Tsukamoto T, Oshiro K, Kinukawa N, Ogawa O (2007) Seasonal alterations in nocturia and other storage symptoms in three Japanese communities. Urology 69(5):864–870CrossRefPubMedGoogle Scholar
  16. 16.
    Fitzgerald MP, Mulligan M, Parthasarathy S (2006) Nocturic frequency is related to severity of obstructive sleep apnea, improves with continuous positive airways treatment. Am J Obstet Gynecol 194(5):1399–1403CrossRefPubMedGoogle Scholar
  17. 17.
    Stember DS, Weiss JP, Lee CL, Blaivas JG (2007) Nocturia in men. Int J Clin Pract Suppl (155):17–22Google Scholar
  18. 18.
    Tikkinen KA, Auvinen A, Huhtala H, Tammela TL (2006) Nocturia and obesity: a population-based study in Finland. Am J Epidemiol 163(11):1003–1011CrossRefPubMedGoogle Scholar
  19. 19.
    Shiri R, Hakama M, Hakkinen J, Auvinen A, Huhtala H, Tammela TL, Koskimaki J (2008) The effects of lifestyle factors on the incidence of nocturia. J Urol 180(5):2059–2062CrossRefPubMedGoogle Scholar
  20. 20.
    Asplund R, Aberg HE (2004) Nocturia in relation to body mass index, smoking and some other life-style factors in women. Climacteric 7(3):267–273CrossRefPubMedGoogle Scholar
  21. 21.
    Haass M, Kubler W (1997) Nicotine and sympathetic neurotransmission. Cardiovasc Drugs Ther 10(6):657–665CrossRefPubMedGoogle Scholar
  22. 22.
    Feldstein CA (2013) Nocturia in arterial hypertension: a prevalent, underreported, and sometimes underestimated association. J Am Soc Hypertens 7(1):75–84CrossRefPubMedGoogle Scholar
  23. 23.
    Daneshgari F, Liu G, Birder L, Hanna-Mitchell AT, Chacko S (2009) Diabetic bladder dysfunction: current translational knowledge. J Urol 182(6 Suppl):S18–S26CrossRefPubMedGoogle Scholar
  24. 24.
    Homma Y, Yamaguchi T, Kondo Y, Horie S, Takahashi S, Kitamura T (2002) Significance of nocturia in the International Prostate Symptom Score for benign prostatic hyperplasia. J Urol 167(1):172–176CrossRefPubMedGoogle Scholar
  25. 25.
    Weiss JP, Blaivas JG, Stember DS, Brooks MM (1998) Nocturia in adults: etiology and classification. Neurourol Urodyn 17(5):467–472CrossRefPubMedGoogle Scholar
  26. 26.
    Zhang W, Song Y, He X, Xu B, Huang H, He C, Hao L, Li Y (2005) Prevalence and risk factors of lower urinary tract symptoms in Fuzhou Chinese women. Eur Urol 48(2):309–313CrossRefPubMedGoogle Scholar
  27. 27.
    Timur-Tashan S, Beji NK, Aslan E, Yalcin O (2012) Determining lower urinary tract symptoms and associated risk factors in young women. Int J Gynaecol Obstet 118(1):27–30CrossRefPubMedGoogle Scholar
  28. 28.
    Snooks SJ, Setchell M, Swash M, Henry MM (1984) Injury to innervation of pelvic floor sphincter musculature in childbirth. Lancet 2(8402):546–550CrossRefPubMedGoogle Scholar
  29. 29.
    Schatzl G, Temml C, Schmidbauer J, Dolezal B, Haidinger G, Madersbacher S (2000) Cross-sectional study of nocturia in both sexes: analysis of a voluntary health screening project. Urology 56(1):71–75CrossRefPubMedGoogle Scholar
  30. 30.
    Tikkinen KA, Johnson TN, Tammela TL, Sintonen H, Haukka J, Huhtala H, Auvinen A (2010) Nocturia frequency, bother, and quality of life: how often is too often? A population-based study in Finland. Eur Urol 57(3):488–496CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Yuliang Wang
    • 1
    • 2
  • Hao Hu
    • 1
  • Kexin Xu
    • 1
    Email author
  • Xiaopeng Zhang
    • 1
  • Xiaofeng Wang
    • 1
  • Yanqun Na
    • 1
  • Xiaoping Kang
    • 3
  1. 1.Urology DepartmentPeking University People’s HospitalBeijingPeople’s Republic of China
  2. 2.School of Biomedical Sciences, Faculty of MedicineThe Chinese University of Hong KongHong KongPeople’s Republic of China
  3. 3.Department of Clinical Epidemiology and BiostatisticsPeking UniversityBeijingPeople’s Republic of China

Personalised recommendations