Management Strategies for Nocturia

Curr Urol Rep. 2019 Nov 9;20(11):75. doi: 10.1007/s11934-019-0940-2.

Abstract

Purpose of review: Nocturia is defined as awakening due to the desire to void during a period of intended sleep. The pathophysiology of nocturia is multifactorial and management remains a challenge. Herein, we provide an overview of the management strategies for nocturia and summarize the existing evidence for treatment of nocturia across the condition's broad etiologic categories: nocturnal polyuria, diminished bladder capacity, and global polyuria.

Recent findings: Treatment should begin with behavioral modification. A high level of evidence supports the efficacy of desmopressin in the treatment of nocturnal polyuria. Data supporting the efficacy of α-blockers, antimuscarinics, and surgical bladder outlet procedures in the treatment of nocturia remains limited. Treatment options for nocturia are determined by underlying mechanism. Desmopressin is effective in treating nocturnal polyuria. Surgical intervention, α-blockers, and antimuscarinics may improve nocturia when associated with lower urinary tract symptoms or overactive bladder in the setting of diminished bladder capacity.

Keywords: Diminished bladder capacity; Global polyuria; Nocturia; Nocturia management; Nocturia treatment; Nocturnal polyuria.

Publication types

  • Review

MeSH terms

  • Adrenergic alpha-Antagonists / therapeutic use
  • Antidiuretic Agents / therapeutic use
  • Behavior Therapy
  • Deamino Arginine Vasopressin / therapeutic use
  • Humans
  • Lower Urinary Tract Symptoms / complications
  • Muscarinic Antagonists / therapeutic use
  • Nocturia / etiology*
  • Nocturia / therapy*
  • Organ Size
  • Polyuria / complications
  • Urinary Bladder / pathology*
  • Urinary Bladder, Overactive / complications

Substances

  • Adrenergic alpha-Antagonists
  • Antidiuretic Agents
  • Muscarinic Antagonists
  • Deamino Arginine Vasopressin