12/31/2023 0 Comments Nocturia and nocturnal polyuria![]() The number of nocturia episodes was self-reported by the patient during clinical interview, and recorded at each visit. Other testing, such as bladder diary (BD) and/or urodynamics, was performed at the physician’s discretion. Physical examination, post-void residual and urine analysis were routinely performed. The patients’ evaluation was not standardised and was individualised to each patient’s characteristics and clinical presentation. The secondary objective was to assess the predictive factors of therapeutic management failure. The primary objective of the present study was to report the current clinical features, treatment patterns and outcomes of female patients who were seen at a tertiary referral centre with a primary diagnosis of nocturia. ![]() To date, the ICS does not distinguish male and female nocturia. However, the literature on clinical presentations, treatment and outcomes of nocturia in female patients to confirm this hypothesis is scarce. The possibly slightly higher prevalence of overactive bladder (OAB) in women vs men could also suggest a greater pathophysiological contribution of bladder storage issues likely to influence clinical features and therapeutic management. As a result, one may assume that therapeutic patterns and response to treatment may differ according to gender for nocturia. The prostate can play a significant role in men, whilst gender-specific factors may be involved in women, such as hormonal status and dysfunctions, parity, history of gynaecological surgery, etc. Although both genders share several pathophysiological mechanisms, the genesis of nocturia in male and female patients differs widely. obstructive sleep apnoea, endocrine dysfunction, cardiovascular disease, etc.) to the symptom of nocturia in both men and women. This finding has assisted in the increasing recognition of the pathophysiological contributions of kidney and bladder dysfunctions, and numerous non-urological comorbidities (e.g. However, over the past decade, several studies have shown that nocturia is as prevalent in women as it is in men and suggesting that this symptom may have been overlooked and underestimated in female patients for a long time. It has been viewed for long time as being a predominantly male symptom caused by BPH and gathered with other voiding and storage LUTS, under the umbrella term ‘prostatism’. Nocturia is one of the most common and bothersome LUTS. A smaller number of nocturia episodes was the only predictive factor of therapeutic management failure in multivariate analysis (odds ratio 0.10 P = 0.01).Ĭonclusions: Whilst the prevalence of nocturnal polyuria in women with nocturia is high, the therapeutic management until 2016 seemed to rely mostly upon overactive bladder medications with a relatively low success rate.Ībbreviations: BD: bladder diary BPS: bladder pain syndrome ICD(−9)-(10): International Classifications of Disease (ninth revision) (10th revision) NPI: Nocturnal Polyuria Index OAB: overactive bladder OR: odd ratio POP: pelvic organ prolapse There was no statistically significant association between any of the bladder diary findings and treatment outcomes. At the latest considered visit, 80 patients reported improvement in nocturia (45.5%) and there was a mean – 0.8 decrease in the number of nocturia episodes from 4 to 3.2, which was statistically significant ( P < 0.001). ![]() Anticholinergics were the most commonly initiated treatment (47.2% of patients). Within the first two visits, 72.7% of patients had started a treatment beyond behavioural therapies. The prevalence of nocturnal polyuria, reduced bladder capacity, and global polyuria were 75%, 40.2%, and 18.1%, respectively. Results: In all, 239 female patients were included for analysis. The primary endpoint was patient-reported improvement assessed at each follow-up visit and the change in the number of nocturia episodes. Up to three visits within a 12-month period from the time of presenting were reviewed. Patients and methods: A retrospective chart review of all new female patients seen in a single-centre functional urology practice with the diagnosis of nocturia was performed. Objective: To report the current clinical features, treatment patterns and outcomes of female patients who were seen at a tertiary referral centre with a primary diagnosis of nocturia, and to assess the predictive factors of therapeutic management failure.
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