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Diagnosis and management of nocturia in current clinical practice: who are nocturia patients, and how do we treat them?

  • Siri Drangsholt
  • Maria Juliana Arcila Ruiz
  • Benoit Peyronnet
  • Nirit Rosenblum
  • Victor Nitti
  • Benjamin Brucker
Original Article

Abstract

Objective

To characterize the current evaluation, and efficacy of treatments in patients with the primary complaint of nocturia.

Methods

A retrospective chart review was performed of new patient encounters seen in a tertiary urology practice from May 2010 to September 2016 with the primary diagnosis of nocturia (ICD-9 788.43 and ICD-10 R35.1).

Results

595 patients were identified. 403 met inclusion criteria. The median patient reported that nocturia episodes were 4 (1–20). 192 patients (48%) reported previous treatment for nocturia. After the index visit, a bladder diary (BD) was utilized in 50% of patients, with a 62% (n = 124) completion rate at follow-up visit. On BD analysis, the most common etiologies of nocturia were nocturnal polyuria 76% (n = 90) and overactive bladder in 21% (n = 26). Patient reported improvement with therapy after BD completion was 46% (n = 34), similar to patients without voiding diaries (43% improvement, n = 153). Anticholinergics and alpha blockers were the most commonly recommended drug, but no specific medication was associated with nocturia improvement. Oral desmopressin was used in 5% of patients.

Conclusion

Nocturia is a common condition and very commonly patients have sought treatment prior to presentation. Bladder diaries were recommended to half of the patients. Patient reported that improvement did not seem to correlate with completion of a bladder diary. Though most patients had NP the use of desmopressin was very low. Current treatments used in managing nocturia may lack efficacy.

Keywords

Nocturia Frequency volume chart Desmopressin Nocturnal polyuria 

Notes

Acknowledgements

None.

Author contributions

SD protocol/project development, data collection, data analysis, manuscript writing/editing. BP manuscript writing/editing. AR data collection, data analysis. NR data collection. VN data collection, manuscript writing/editing, data analysis. BB protocol/project development, manuscript writing/editing

Funding

There was no source of funding from any company.

Compliance with ethical standards

Conflict of interest

Siri Drangsholt: None; Maria Juliana Arcila Ruiz: None; Benjamin Brucker: Avadel, Serenity, Allergan, Medtronic, Watkins-Conti, Ipsen; Avadel- Consultant and Speaker; Serenity—Consultant; Allergan—Speaker, Consultant, Investigator; Metronic- Investigator; Watkins-Conti- advisor; Ipsen—Investigator; Victor Nitti: Owns stock in Serenity; Benoit Peyronnet: Astellas, Medtronic, Allergan, Boston Scientific, Ipsen; Astellas—Consultant; Allergan—Consultant; Metronic—Consultant; Boston Scientific—Consultant; Ipsen—Investigator; Nirit Rosenblum: None.

Ethical approval

This study was approved by the New York University Institutional Review Board as it involved research on human subjects.

Informed consent

This study was retrospective using de-identified data and thus informed consent was not needed.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of UrologyNew York University School of MedicineNew YorkUSA
  2. 2.Division of Female Pelvic Medicine and Reconstructive SurgeryNew York University Langone HealthNew YorkUSA
  3. 3.Department of Urology, Service D’UrologieUniversity of RennesRennesFrance

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