Demystifying Nocturia: Identifying the Cause and Tailoring the Treatment

Paula Laureanno, RN; Pamela Ellsworth, MD, FACS, FAAP

Disclosures

Urol Nurs. 2010;30(5):276-287. 

In This Article

Summary

Nocturia is a prevalent and bothersome symptom that has significant impact on health and quality of life. Terminology has now been adopted that allows health care providers across all specialties to "speak the same language" as it pertains to nocturia. This will greatly facilitate the evaluation and subsequent management of nocturia. The voiding diary is the cornerstone to the evaluation of a patient presenting with nocturia, and the history and physical examination allow for further evaluation of treatable causes of nocturia. Classifying nocturia into one of four categories (diurnal polyuria, nocturnal polyuria, bladder storage problem, and mixed nocturia) allows for a tailored treatment regimen. Use of a diagnostic and treatment algorithm can help direct clinical decision making in nursing practice. Although behavioral and lifestyle changes may help the overall population suffering from nocturia, an individualistic approach identifying and treating medical conditions that cause nocturia with appropriate pharmacologic therapies may have a significant impact on nocturia.

Desmopressin has been demonstrated to be effective in those individuals suffering from nocturnal polyuria. Some improvement in nocturnal voids and nocturnal OAB-related voids has been demonstrated with various antimuscarinic agents. In males suffering from bladder outlet obstruction secondary to BPH, reduction in nocturnal voids has been demonstrated in clinical trials with both alpha-adrenergic receptor blockers as well as 5-alpha-reductase inhibitors. Currently, there are no pharmacologic therapies approved by the Food and Drug Administration for the treatment of nocturia; however, two formulations of desmopressin are currently in clinical trials.

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