Incidence and Remission of Nocturia: A Systematic Review and Meta-analysis

Jori S Pesonen; Rufus Cartwright; Altaf Mangera; Henrikki Santti; Tomas L Griebling; Alexey E Pryalukhin; Jarno Riikonen; Riikka M Tähtinen; Arnav Agarwal; Johnson F Tsui; Camille P Vaughan; Alayne D Markland; Theodore M Johnson 2nd; Riikka Fonsell-Annala; Charlie Khoo; Teuvo L J Tammela; Yoshitaka Aoki; Anssi Auvinen; Diane Heels-Ansdell; Gordon H Guyatt; Kari A O Tikkinen

doi:10.1016/j.eururo.2016.02.014

Incidence and Remission of Nocturia: A Systematic Review and Meta-analysis

Eur Urol. 2016 Aug;70(2):372-81. doi: 10.1016/j.eururo.2016.02.014. Epub 2016 Feb 20.

Authors

Jori S Pesonen¹, Rufus Cartwright², Altaf Mangera³, Henrikki Santti⁴, Tomas L Griebling⁵, Alexey E Pryalukhin⁶, Jarno Riikonen⁷, Riikka M Tähtinen⁸, Arnav Agarwal⁹, Johnson F Tsui¹⁰, Camille P Vaughan¹¹, Alayne D Markland¹¹, Theodore M Johnson 2nd¹¹, Riikka Fonsell-Annala¹², Charlie Khoo¹³, Teuvo L J Tammela⁷, Yoshitaka Aoki¹⁴, Anssi Auvinen¹⁵, Diane Heels-Ansdell¹⁶, Gordon H Guyatt¹⁷, Kari A O Tikkinen¹⁸

Affiliations

¹ Department of Urology, Päijät-Häme Central Hospital, Lahti, Finland; Department of Urology, Tampere University Hospital and Medical School, University of Tampere, Tampere, Finland.
² Department of Epidemiology and Biostatistics, Imperial College London, London, UK; Department of Urogynaecology, Imperial College London, London, UK.
³ Department of Urology, Sheffield Teaching Hospitals, Sheffield, UK.
⁴ Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
⁵ Department of Urology, University of Kansas and The Landon Center On Aging, Kansas City, KS, USA.
⁶ North-Western State Medical University named after I.I. Mechnikov, Department of Urology, Saint Petersburg, Russia; Department of Pathology, Saarland University Medical Center, Homburg, Germany.
⁷ Department of Urology, Tampere University Hospital and Medical School, University of Tampere, Tampere, Finland.
⁸ Department of Obstetrics and Gynecology, Kuopio University Hospital, Kuopio, Finland.
⁹ Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
¹⁰ Department of Urology, Lenox Hill Hospital, New York, NY, USA.
¹¹ Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research Education and Clinical Center, Atlanta, GA, USA.
¹² Department of Urology, Porvoo Hospital, Porvoo, Finland.
¹³ Department of Urology, Royal Free Hospital, London, UK.
¹⁴ Department of Urology, University of Fukui, Faculty of Medical Sciences, Fukui, Japan.
¹⁵ School of Health Sciences, University of Tampere, Tampere, Finland.
¹⁶ Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
¹⁷ Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada.
¹⁸ Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland. Electronic address: kari.tikkinen@gmail.com.

PMID: 26905787
DOI: 10.1016/j.eururo.2016.02.014

Abstract

Context: Although vital for decision-making about management, the natural history of nocturia remains uncertain. A systematic review would clarify the issue, but because natural history reviews are uncommon it would require methodological innovations.

Objective: To estimate the incidence and remission of nocturia, and refine methods for meta-analyses assessing natural history.

Evidence acquisition: We conducted a comprehensive search of PubMed, Scopus, and Cumulative Index of Nursing and Allied Health Literature databases and abstracts of major urologic meetings as far as August 31, 2015. Random effects meta-analyses addressed incidence/remission rates of nocturia; meta-regression explored potential determinants of heterogeneity. Studies were categorized as either low or high risk of bias using a novel instrument specifically designed for longitudinal symptom studies aimed at the general population.

Evidence synthesis: Of 4165 potentially relevant reports, 16 proved eligible. Pooled estimates from 13 studies (114 964 person-years of follow-up) demonstrated that annual incidence was strongly associated with age: 0.4% (0-0.8%) for adults aged < 40 yr; 2.8% (1.9-3.7%) for adults aged 40-59 yr; and 11.5% (9.1-14.0%) for adults aged ≥ 60 yr. Of those with nocturia, each year 12.1% (9.5-14.7%) experienced remission.

Conclusions: The available evidence suggests that nocturia onset is strongly associated with age, with much higher rates in those over 60 yr; remission occurs in approximately 12% each year. These estimates can aid with management decisions and counseling related to nocturia.

Patient summary: We reviewed all previous studies of progression of night-time urination (nocturia). We found that in any given year 0.4% of adults aged < 40 yr, 3% of adults aged 40-59 yr, and 12% of adults aged ≥ 60 yr will develop nocturia, while overall 12% of those with nocturia will improve. These findings may be helpful in making decisions about coping with or treating nocturia.

Keywords: Epidemiology; Incidence; Lower urinary tract symptoms; Meta-analysis; Meta-regression; Nocturia; Remission; Systematic review.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Age of Onset
Disease Management
Humans
Incidence
Nocturia* / epidemiology
Nocturia* / therapy

Grants and funding

G1100377/MRC_/Medical Research Council/United Kingdom