Ilse Hofmeester

The Association between Nocturia and Nocturnal Polyuria in Clinical and Epidemiological Studies: A Systematic Review and Meta-Analyses

PURPOSE We determined the relationship between nocturia and nocturnal polyuria. MATERIALS AND METHODS The PubMed® and Embase® databases were searched for studies written in English, German, French or Dutch with original data on adult participants in an investigation of the relationship between nocturia and nocturnal polyuria. A meta-analysis of the difference in mean nocturnal voiding frequencies between patients with and without nocturnal polyuria was conducted. Nocturnal polyuria risk was compared between participants with and without nocturia, and the resulting odds ratio was subsequently converted to relative risk with 95% CIs. RESULTS From 511 references identified we selected 78 publications of 66 studies, 15 of which met the inclusion criteria for this study. Quality scores of studies were generally high for internal validity but low for external validity. In 7 studies (1,416 participants) we estimated a standardized mean difference of 0.59 (95% CI 0.29-0.89) for nocturnal voids between nocturnal polyuria and nonnocturnal polyuria cases. In 8 other studies (with 2,320 participants) we calculated a pooled OR of 4.99 (3.92-6.37) for nocturnal polyuria in individuals with nocturia. The corresponding RR, based on a nocturnal polyuria risk in the pooled population of 63.8%, was 1.41 (1.37-1.44). CONCLUSIONS The association between nocturia and nocturnal polyuria is apparent and robust. However, the clinical importance of the association appears to be less obvious than previously suggested based on single studies. The observed high prevalence of nocturnal polyuria, as a result of the applied International Continence Society definition, may be responsible for this discrepancy.

Impact of the International Continence Society (ICS) report on the standardisation of terminology in nocturia on the quality of reports on nocturia and nocturnal polyuria: a systematic review.

To systematically review and evaluate the impact of the International Continence Society (ICS)‐2002 report on standardisation of terminology in nocturia, on publications reporting on nocturia and nocturnal polyuria (NP). In 2002, the ICS defined NP as a Nocturnal Polyuria Index (nocturnal urine volume/total 24‐h urine volume) of >0.2–0.33, depending on age.

Predictors for a positive outcome of adapted clinical dry bed training in adolescents and adults with enuresis

Adapted Dry Bed Training (Adapted DBT) has been shown to be effective in therapy‐resistant adolescents and adults with enuresis. Given the substantial impact of enuresis and the time‐consuming nature of Adapted DBT, we investigated which patients benefited most from Adapted DBT. Therefore, we identified predictors for a successful treatment response to Adapted DBT in this population.

Desmopressine helpt niet bij nycturie

SamenvattingEén keer per nacht of vaker ontwaken om te plassen (nycturie) komt veel voor. Nycturie neemt toe met de leeftijd, leidt tot minder slaap en een lagere kwaliteit van leven. Desmopressine zou nycturie tegengaan, maar de auteurs van een recente Cochrane-review vonden daarvoor geen bewijs.

Reference values for frequency volume chart and uroflowmetry parameters in adolescent and adult enuresis patients

Reference values of Frequency Volume Chart (FVC) and uroflowmetry parameters for adolescent and adult enuresis patients are lacking. In this study, we aim to describe those parameters, in order to interpret findings from FVCs and uroflowmetries in those patients.

Moderate agreement between bladder capacity assessed by frequency volume charts and uroflowmetry, in adolescent and adult enuresis patients

Frequency Volume Charts (FVC) are recommended for the evaluation of enuretic patients. Although this is a good instrument for the assessment of functional bladder capacity, it is known that patient compliance could introduce problems. Therefore, we assessed whether uroflowmetry and post‐void residual volume could replace FVC recordings in specific cases, by comparing the bladder capacity as measured by FVC or uroflowmetry.

High short-term effectiveness of modulated dry bed training in adolescents and young adults with treatment-resistant enuresis

Hypothesis / aims of study Patients with overactive bladder syndrome refractory to behavioural interventions and pharmacotherapy remain a difficult-to-treat population. Second-line treatment options include either intravesical injection of botulinum toxin A or sacral neuromodulation (SNM). Whilst neuromodulation requires surgical intervention for both test evaluations and permanent implantation, the use of intravesical botulinum toxin requires repeated treatments, with the potential for development of urinary tract infections, incomplete emptying and need for intermittent self-catheterisation.

608 High short-term effectiveness of modulated dry bed training in adolescents and young adults with treatment-resistant enuresis

INTRODUCTION & OBJECTIVES: Two percent of adolescents and young adults suffer from therapy-resistant enuresis, with considerable negative impact on self-esteem and relationships. We evaluated the effect of a Modulated Dry Bed Training (MDBT) in a previously therapyresistant group of adolescents with enuresis, provided by a specialized enuresis-centre. MATERIAL & METHODS: Descriptive, retrospective cohort study. Between January 2003 and July 2013, 907 patients were treated by MDBT: a 5-days/4-nights in-hospital group training consisting of enuresis-anamnesis, explanation, alarm treatment, day-time activities with the purpose of increasing self-esteem and group contact. Structured follow-up was performed by telephone contact. Patients data were collected from the medical files. At 6 weeks, 3 and 6 months success of treatment was determined using ICCS-definitions. Secondary measurements included use of medication after treatment. Sensitivity analyses were performed to control for missing values. Differences between the subgroups gender, age and degree of enuresis were tested by Chi-Square test. RESULTS: Patients were aged 11-42 years (median 15, IQR 3.5), 34% female. At baseline, 81% had non-monosymptomatic enuresis, 65% primary enuresis, and 46% frequent enuresis (≥4 days/week). After 6 weeks, 46% (CI95% 43-50) and 41% of patients had a full or partial response, respectively. After 6 months this accounted for 68% (CI95% 65-72) and 25%. Females more often had a full response than males in all time frames. CONCLUSIONS: MBDT appeared to be highly effective on short term in adolescents with therapy-resistant enuresis. (Table Presented).

Impact of the International Continence Society (ICS) report on the standardisation of terminology in nocturia on the quality of reports on nocturia and nocturnal polyuria: a systematic review: Impact of the ICS-2002 report on standardisation of terminology in nocturia

To systematically review and evaluate the impact of the International Continence Society (ICS)‐2002 report on standardisation of terminology in nocturia, on publications reporting on nocturia and nocturnal polyuria (NP). In 2002, the ICS defined NP as a Nocturnal Polyuria Index (nocturnal urine volume/total 24‐h urine volume) of >0.2–0.33, depending on age.

Impact of the International Continence Society (ICS) report on the standardisation of terminology in nocturia on the quality of reports on nocturia and nocturnal polyuria

To systematically review and evaluate the impact of the International Continence Society (ICS)‐2002 report on standardisation of terminology in nocturia, on publications reporting on nocturia and nocturnal polyuria (NP). In 2002, the ICS defined NP as a Nocturnal Polyuria Index (nocturnal urine volume/total 24‐h urine volume) of >0.2–0.33, depending on age.