MODERN VIEW OF NOCTURIA IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA

Abstract

Nocturia, awaking from sleep to void, has a negative impact on health and well-being. Nocturia traditionally has been regarded as a predominantly male condition, but it is just as prevalent in women as in men. Urologists and general practitioners are becoming increasingly aware of and interested in nocturia, as indicated by the recent increase in large epidemiologic studies and analyses and by initiatives such as the Nocturia Think Tank and The Consensus Statement from the Interdisciplinary Conference on Nocturia. Nocturia is a common symptom of many conditions and is encountered in patients presenting to services across different medical specialities and health disciplines. The causal pathway of nocturia is multi-factorial and differs between patients. There is currently no symptom-specific clinical algorithm for all-cause diagnosis of nocturia. A thorough history and assessment of number and times of voids, void volume, and fluid intake is essential for determining the etiology of a patient’s nocturia. With data obtained from the frequency-volume chart (FVC), which is used to collect quantitative voiding data, a patient’s nocturia may be classified as global polyuria, nocturnal polyuria, reduced bladder capacity, or a combination of these categories. Global polyuria is defined as 24-hr urinary output that exceeds 40 ml/kg body weight and results in increased 24-hr urinary frequency. Nocturia is a complex multifactorial condition that requires careful evaluation for appropriate diagnosis. The FVC is an essential evaluation tool that can facilitate accurate identification of the potential multiple causes of nocturia in an individual patient, providing evidence by which the etiology of nocturia can be categorized into one or a combination of categories of sleep disorders, nocturnal polyuria, global polyuria, and reduced bladder capacity. The role of the circadian clock in the pathophysiology of nocturia deserves further attention.

Keywords

• nocturia
• global polyuria
• nocturnal polyuria
• reduced bladder capacity
• sleep disorders
• and circadian clock disorders