Nocturia: Evaluation and Management

Abstract

Purpose of ReviewNocturia, defined as waking to pass urine during the main sleep period, is among the most common and bothersome lower urinary tract symptoms. In this review, the current literature as it pertains to the etiology, evaluation, and management of nocturia is addressed.Recent FindingsOver the past decade, there has been increased interest in nocturia as a specific lower urinary tract symptom, with efforts made to improve understanding of underlying mechanisms and consequences. Several publications now classify nocturia according to underlying cause (such as nocturnal polyuria), in that what was a previously overlooked and understudied topic, emerges as a distinct urinary complaint carrying significant morbidity. Multiple randomized controlled trials demonstrate effective medical and surgical therapy and provide the basis for modern guidelines.SummaryNocturia is a highly prevalent symptom associated with reduced quality of life, morbidity, and mortality. Proper evaluation including analysis of a frequency-volume chart, will determine treatment options based on underlying etiology including nocturnal polyuria, global polyuria, and reduced bladder capacity. Desmopressin is shown to be an effective treatment for nocturnal polyuria. Evidence supporting other treatment options including surgical intervention, α-blockers, and antimuscarinics remains limited. Further research is needed to integrate and emphasize the importance of a proper evaluation of nocturia and its subsequent management for use in modern guidelines.