Skip to main content

Advertisement

SpringerLink
Log in

Nocturia: its characteristics, diagnostic algorithm and treatment

  • Nephrology - Review
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Nocturia is the complaint that an individual has to wake up at night one or more times to urinate. It is a frequent condition among older adults and entails detrimental effects with regard to sleeping, sexual activity, comfort, depression, mental function and vitality. It is clinically important to distinguish it from global polyuria, defined as a urinary rate ≥ 125 ml/h (3000 ml/day), as well as from nocturnal polyuria, which is an abnormally large volume of urine during sleep associated with a decreased daytime urine production. A Frequency Volume Chart (FVC), overnight water deprivation test with renal concentrating capacity test, and the nocturnal bladder capacity index are some of the methods that help establish the underlying pathology of this condition and hence define an adequate treatment plan.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Musso CG, Vilas M (2019) Water electrolyte, and acid-base disorders in the elderly. In: Musso CG, Jauregui JR, Macías-Núñez JF, Covic A (eds) Clinical nephrogeriatrics. An evidence-based guide. Springer, Cham

    Chapter  Google Scholar 

  2. Mahon M, Amaechi G, Slattery F, Sheridan AL, Roche E (2018) Fifteen-minute consultation: polydipsia, polyuria or both. Arch Dis Child Educ Practice 104:141–145

    Article  Google Scholar 

  3. Musso CG, Juarez R, Terrasa S, Gonzalez-Torres H, Aroca-Martinez G (2019) Osmotic diuresis in chronic kidney disease: its significance and clinical utility. Int Urol Nephrol 51(8):1403–1406

    Article  Google Scholar 

  4. Udo Y, Nakao M, Honjo H, Ukimura O, Kawauchi A, Kitakoji H, Miki T (2010) Analysis of nocturia with 24-h urine volume, nocturnal urine volume, nocturnal bladder capacity and length of sleep duration: concept for effective treatment modality. BJUI Int 107:791–798

    Article  Google Scholar 

  5. Bosch R, Everaert K, Weiss J, Hashim H, Rahnama MS, Goessaert AS, Aizen J (2016) Would a new definition and classification of nocturia and nocturnal polyuria improve our management of patients? ICI-RS 2014. Neurol Urodynam 35:283–287

    Article  Google Scholar 

  6. Weiss J, Juul KV, Wein AJ (2014) Management of nocturia: the role of antidiureic pharmacotherapy. Neurol Urodynam 33:19–24

    Article  Google Scholar 

  7. Graham JN, Desroches BR, Weiss JP (2014) Nocturia causes vary with each decade. Curr Opin Urol 24:38–362

    Article  Google Scholar 

  8. Romain J, Torny F, Dumas JP, Gamé X, Descazeaud A (2015) La polyurie nocturne est-elle plus fréquente chez les patients parkinsoniens? Progress en urologie 25(6):312–317

    Article  CAS  Google Scholar 

  9. van Haarst EP, Bosch R (2012) A cut off value based on analysis of a reference population decrease overestimation of the prevalence of nocturnal polyuria. J Urol 188:869–874

    Article  Google Scholar 

  10. Dani H, Esdaille A, Weiss JP (2016) Nocturia: aetiology and treatment in adults. Nat Rev Urol 13(10):573–583

    Article  Google Scholar 

  11. Weiss JP (2012) Nocturia: focus on etiology and consequences. Rev Urol 14(3/4):48–55

    Google Scholar 

  12. Robinson D, Suman S (2018) Managing nocturia: the multidisciplinary approach. Maturitas 116:123–129

    Article  Google Scholar 

  13. Tikkinen KA, Tammela TL, Rissanen AM, Valpas A, Huhtala H, Auvinen A (2007) Is the prevalence of overactive bladder overestimated? A population-based study in Finland. PLoS ONE 2(2):e195. https://doi.org/10.1371/journal.pone.0000195

    Article  Google Scholar 

  14. Häkkinen J, Hakama M, Shiri R, Auvinen A, Tammela T, Koskimäki T (2006) Incidence of nocturia in 50 to 80-year-old finnish men. J Urol 176(6 Pt 1):2541–2545

    Article  Google Scholar 

  15. Goessaert AS, Walle JV, Bosch R, Hoebeke P, Everaert K (2016) Nocturnal polyuria: excess of nocturnal urine production, excess of definitions-influence on renal function profile. J Urol 195(3):670–676

    Article  Google Scholar 

  16. Bruner A, Riss P (2011) Nocturia in woman. Maturitas 70:16–21

    Article  Google Scholar 

  17. Van Doorn B, Bosch R (2011) Nocturia in older men. Maturitas 71:8–12

    Article  Google Scholar 

  18. Peyronnet B, Pradere F, Bruyere F (2014) Prise en charge de la nycturie: una entité nosologique au sein des trubles mictionnels de l’homme. Prog Urol 2(24):80–86

    Article  Google Scholar 

  19. Pesonen JS, Cartwright R, Vernooij RWM, Aoki Y, Agarwal A, Mangera A, Markland AD, Tsui JF, Santti H, Griebling TL, Pryalukhin AE, Riikonen J, Tähtinen RM, Vaughan CP, Johnson TM 2nd, Auvinen A, Heels-Ansdell D, Guyatt GH, Tikkinen KAO (2020) The impact of nocturia on mortality: a systematic review and meta-analysis. J Urol 203(3):486–495

    Article  Google Scholar 

  20. Araujo AB, Yaggi HK, Yang M, McVary KT, Fang SC, Bliwise DL (2014) Sleep related problems and urological symptoms: testing the hypothesis of bidirectionality in a longitudinal, population based study. J Urol 191(1):100–106. https://doi.org/10.1016/j.juro.2013.07.011

    Article  Google Scholar 

  21. Breyer BN, Shindel AW, Erickson BA, Blaschko SD, Steers WD, Rosen RC (2013) The association of depression, anxiety and nocturia: a systematic review. J Urol 190(3):953–957

    Article  Google Scholar 

  22. Blanker MH, Groeneveld F, Bohnen AM, Bernsen RM, Prins A, Thomas S, Ruud Bosch JL (2001) Voided volumes: normal values and relation to lower urinary tract symptoms in elderly men, a community-based study. Urology 57(6):1093–1098

    Article  CAS  Google Scholar 

  23. Smith AL, Wein AJ (2011) Outcomes of pharmacological management of nocturia with non-antidiuretic agents: does statistically significant equal clinically significant? BJU Int 107(10):1550–1554

    Article  CAS  Google Scholar 

  24. Hofmeester I, Kollen BJ, Steffens MG, Bosch JL, Drake MJ, Weiss JP, Blanker MH (2014) The association between nocturia and nocturnal polyuria in clinical and epidemiological studies: a systematic review and meta-analyses. J Urol 191(4):1028–1033

    Article  Google Scholar 

  25. Weiss JP, Bosch JL, Drake M, Dmochowski RR, Hashim H, Hijaz A, Johnson TM, Juul KV, Nørgaard JP, Norton P, Robinson D, Tikkinen KA, Van Kerrebroeck PE, Wein AJ (2012) Nocturia think tank: focus on nocturnal polyuria. Neurourol Urodyn 31(3):330–339

    Article  Google Scholar 

  26. Madersbacher S, Cornu JN (2013) Norcturnal polyuria: It´s all about definition, and be patient. Eur Urol 63:548–550

    Article  Google Scholar 

Download references

Funding

No funds were received for performing this article.

Author information

Authors and Affiliations

  1. Physiology Department, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Nahir Aucar, Ines Fagalde, Akemi Zanella, Olivia Capalbo & Carlos G. Musso

  2. Universidad del Norte, Barranquilla, Colombia

    Gustavo Aroca-Martinez

  3. Facultad de Ciencias de la Salud, Universidad Simón Bolivar, Barranquilla, Colombia

    Gustavo Aroca-Martinez & Carlos G. Musso

  4. Urology Division, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Gabriel Favre

Authors
  1. Nahir Aucar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ines Fagalde
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Akemi Zanella
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Olivia Capalbo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gustavo Aroca-Martinez
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gabriel Favre
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Carlos G. Musso
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Carlos G. Musso.

Ethics declarations

Conflict of interest

All the authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Aucar, N., Fagalde, I., Zanella, A. et al. Nocturia: its characteristics, diagnostic algorithm and treatment. Int Urol Nephrol 55, 107–114 (2023). https://doi.org/10.1007/s11255-022-03317-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-022-03317-y

Keywords

Search

Navigation