TY - JOUR
T1 - A contemporary assessment of nocturia
T2 - Definition, epidemiology, pathophysiology, and management - A systematic review and meta-analysis
AU - Cornu, Jean Nicolas
AU - Abrams, Paul
AU - Chapple, Christopher R.
AU - Dmochowski, Roger R.
AU - Lemack, Gary E.
AU - Michel, Martin C.
AU - Tubaro, Andrea
AU - Madersbacher, Stephan
N1 - Funding Information:
Financial disclosures: Jean-Nicolas Cornu certifies that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg, employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: Martin C. Michel received research support, consultancy, and/or lecturer honoraria from Allergan, AltheRX, Astellas, Bayer, and Pfizer and is currently an employee of Boehringer Ingelheim. Gary E. Lemack is part of the Astellas speakers bureau and the Pfizer speakers bureau; is speaker, consultant, and involved in clinical trial of Allergan; and is involved in a clinical trial for NIDDK. Stephan Madersbacher is lecturer for Boehringer, Astellas, Allergan, Bayer, Madaus, Pfizer, and Ferring. Roger R. Dmochowski is consultant for Allergan, Merck, Johnson and Johnson, and Ferring. Christopher R. Chapple is consultant and researcher for Allergan, Astellas, Pfizer, Ono, and Recordati and consultant to Lilley and Schering. Paul Abrams is consultant to Astellas, Eli Lilly, and Allergan and lecturer for Ferring and Astellas. Andrea Tubaro is consultant to Allergan, Astellas, Ferring, and MSD; consultant and speaker for Amgen and GSK; investigator for Ipsen and Takeda-Millenium; and investigator and recipient of a research grant from AMS.
PY - 2012/11
Y1 - 2012/11
N2 - Context: Nocturia is a common urologic symptom that has been covered in a variety of reported studies in the literature but is not specifically covered in current guidelines. Objective: To comprehensively review the literature pertaining to the definition, etiologies, and consequences of nocturia and assess the evidence supporting the use of conservative medical and interventional therapy. Evidence acquisition: A literature search was conducted using the keyword nocturia, restricted to articles in the English language, after 2000 and before April 2012, in PubMed/Medline, Embase, Scopus, Web of Science, and Cochrane Library databases. Regarding treatment modalities, studies were included only if nocturia was a primary end point and if the studies were designed as randomized controlled trials without limit of date. When suitable, a meta-analysis was conducted. Papers covering treatment options for nocturia specifically related to nonurologic conditions were excluded. Evidence synthesis: Nocturia is still defined as the symptom of wakening from sleep once or more often to void. The prevalence is high in both genders and increases with age. Frequency-volume charts, which are the pivotal tool of clinical assessment, detect 24-h polyuria, nocturnal polyuria (NP), or reduced nocturnal bladder capacity and help to target specific nonurologic etiologies. Nocturia is a morbid condition that significantly affects quality of life and increases mortality. Besides behavioral measures, validated treatment options include oral desmopressin, which is superior to placebo in treating NP. While the level of evidence for desmopressin is high, limited data support the use of α1-blockers and antimuscarinics; however, only rarely has nocturia been a primary end point when studying these drug classes, and studies have not consistently controlled for the effect of NP. Conclusions: Our knowledge of nocturia, its etiology, and its management has substantially improved in recent years. The evidence available on the management of nocturia remains limited; contributory factors include (1) the complexity of associated conditions, (2) the underuse of objective evaluation tools, and (3) the lack of specific focus on nocturia in clinical trials.
AB - Context: Nocturia is a common urologic symptom that has been covered in a variety of reported studies in the literature but is not specifically covered in current guidelines. Objective: To comprehensively review the literature pertaining to the definition, etiologies, and consequences of nocturia and assess the evidence supporting the use of conservative medical and interventional therapy. Evidence acquisition: A literature search was conducted using the keyword nocturia, restricted to articles in the English language, after 2000 and before April 2012, in PubMed/Medline, Embase, Scopus, Web of Science, and Cochrane Library databases. Regarding treatment modalities, studies were included only if nocturia was a primary end point and if the studies were designed as randomized controlled trials without limit of date. When suitable, a meta-analysis was conducted. Papers covering treatment options for nocturia specifically related to nonurologic conditions were excluded. Evidence synthesis: Nocturia is still defined as the symptom of wakening from sleep once or more often to void. The prevalence is high in both genders and increases with age. Frequency-volume charts, which are the pivotal tool of clinical assessment, detect 24-h polyuria, nocturnal polyuria (NP), or reduced nocturnal bladder capacity and help to target specific nonurologic etiologies. Nocturia is a morbid condition that significantly affects quality of life and increases mortality. Besides behavioral measures, validated treatment options include oral desmopressin, which is superior to placebo in treating NP. While the level of evidence for desmopressin is high, limited data support the use of α1-blockers and antimuscarinics; however, only rarely has nocturia been a primary end point when studying these drug classes, and studies have not consistently controlled for the effect of NP. Conclusions: Our knowledge of nocturia, its etiology, and its management has substantially improved in recent years. The evidence available on the management of nocturia remains limited; contributory factors include (1) the complexity of associated conditions, (2) the underuse of objective evaluation tools, and (3) the lack of specific focus on nocturia in clinical trials.
KW - Antimuscarinics
KW - Desmopressin
KW - Meta-analysis
KW - Nocturia
KW - Nocturnal polyuria
KW - Systematic review
KW - α-Blockers
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U2 - 10.1016/j.eururo.2012.07.004
DO - 10.1016/j.eururo.2012.07.004
M3 - Review article
C2 - 22840350
AN - SCOPUS:84867048874
SN - 0302-2838
VL - 62
SP - 877
EP - 890
JO - European urology
JF - European urology
IS - 5
ER -