In a nutshell
This study reviewed the management options for nocturia. They found that treating nocturia depends on the underlying cause.
Nocturia is defined as waking at night to urinate. It is very common, particularly in older people. Waking up at night to urinate disrupts sleep. This can lead to other issues. Understanding the cause of nocturia is important.
In some cases, there can be more than one factor causing nocturia. A doctor will assess the patient. The patient will then be asked to keep a voiding diary. This records all episodes of urination during a given period. This information can provide a diagnosis. Nocturnal polyuria (NPU) is increased urine production at night. Diminished bladder capacity (DBC) is another nocturia cause. This is when the bladder cannot hold much urine. Global polyuria (GPU) is an increased urine production throughout the day. NPU, DPC, and GPU are the most common physiological causes of nocturia. It is important to review the management strategies of nocturia.
Methods & findings
This study reviewed the management of nocturia. It focused on treating NPU, DPC, and GPU.
NPU should first be treated with behavioral or lifestyle changes (BLCs). BLCs include fluid restriction or optimizing sleep hygiene. Medication adjustments may be needed for patients taking certain anti-hypertensive drugs. This may be necessary for any drug that increases urine production. Diuretics are a type of drug that increases urination. Diuretics administered 6 hours before bedtime can improve NPU and nocturia. Desmopressin is a drug that reduces the amount of water excreted at the kidneys. It should also be considered in the treatment of NPU.
DBC can be treated using a similar strategy to NPU. Surgery may also be an option depending on the cause of DBC. Anti-muscarinic drugs (AMDs) can reduce bladder muscle tension. Combining drugs may be more effective. However, this may not be the safest strategy for older patients. This can increase capacity. GPU is a common symptom of diabetes. Water restriction is most commonly used to improve GPU.
The bottom line
The authors concluded that treating nocturia depends on the underlying cause.
The fine print
These are general recommendations for managing nocturia. The choice of treatment will depend on a patient’s symptoms.
If you have any concerns regarding nocturia management please consult with your doctor.
Published By :
Current urology reports
Nov 09, 2019