Dr. John Heesakkers, the Netherlands (chairman)
Dr. Sandra Nad Skegro, Croatia
Nocturia is a highly prevalent symptom seen in both men and women, and its prevalence increases with age . Nocturia has been defined by the International Continence Society (ICS) as the need to get up once or more to void at night, with each void preceded and followed by sleep . However, the extent and impact of nocturia is often underestimated. Patients are reluctant to consult their doctor to discuss this condition . Also, nocturia is a common cause of sleep disruption leading to reduced quality of life, increased morbidity and impaired daytime activity and work productivity [4-7]. A clear effect is already seen in patients with two nocturia episodes per night.
In real-life practice, nocturia is often inadequately assessed, diagnosed and treated by physicians . Although nocturia is widely recognised as a storage lower urinary tract symptom, and hence linked to underlying pathologies of the lower urinary tract, it actually occurs more often as a consequence of processes unrelated to lower urinary tract dysfunction [4,9]. Both reduced (functional) bladder capacity and increased urine output (24 hours or nocturnal polyuria) can -often simultaneously- be involved in the process. Therefore, it is important to differentiate between these causes in the assessment of nocturia in order to enable appropriate and effective targeting of treatment for a particular patient. A frequency volume chart for 24-72 hours is a key diagnostic tool to capture, quantify and evaluate the pathophysiology of nocturia .
Patients who are bothered by their symptoms and desire treatment should receive appropriate treatment. A variety of treatment options is available, ranging from lifestyle changes and supplements, over pharmacotherapy to surgical options . Regardless of the underlying aetiology of nocturia, lifestyle advice to reduce nocturnal urine volume and episodes of nocturia is often given as a first-line option [1,12]. Most patients, however, will require further treatment, with their individual disease pathophysiology taken into account .
During this session, the faculty will focus via case-based discussions and interactive voting on practical recommendations on how to appropriately diagnose and manage patients with nocturia.
1. Cornu JN, Abrams P, Chapple CR, et al. Eur Urol 2012;62:877-90.
2. van Kerrebroeck P, Abrams P, Chaikin D, et al. Neurourol Urodyn 2002;21:179-83.
3. Chen FY, Dai YT, Liu CK, et al. Int Urogynecol J Pelvic Floor Dysfunct 2007;18:431-6.
4. Dani H, Esdaille A, Weiss JP. Nat Rev Urol 2016;13:573-83.
5. Shao IH, Wu CC, Hsu HS, et al. Clin Interv Aging 2016;11:879-85.
6. Andersson F, Anderson P, Holm-Larsen T, et al. J Med Econ 2016;19:1200-6.
7. Bliwise DL, Rosen RC, Baum N. Neurourol Urodyn 2014;33(Suppl 1):S15-8.
8. Oelke M, Anderson P, Wood R, Holm-Larsen T. Int J Clin Pract 2016;70:940-9.
9. Drake MJ. Eur Urol 2015;67:289-90.
10. Oelke M, Adler E, Marschall-Kehrel D, et al. World J Urol 2014;32:1109-17.
11. Weiss JP, Blaivas JG, Bliwise DL, et al. BJU Int 2011;108:6-21.
12. Gravas S, Cornu JN, Drake MJ, et al. EAU guidelines on the treatment of non-neurogenic male LUTS. Available at: www.uroweb.org (last accessed July 2018).