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.
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. Up to three visits within a 12-month period from the time of presenting were reviewed. The primary endpoint was patient-reported improvement assessed at each follow-up visit and the change in the number of nocturia episodes.
Results
In all, 239 female patients were included for analysis. The prevalence of nocturnal polyuria, reduced bladder capacity, and global polyuria were 75%, 40.2%, and 18.1%, respectively. Within the first two visits, 72.7% of patients had started a treatment beyond behavioural therapies. Anticholinergics were the most commonly initiated treatment (47.2% of patients). 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). There was no statistically significant association between any of the bladder diary findings and treatment outcomes. 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).
Conclusions
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.
Abbreviations
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
This article reports on the current clinical features, treatment patterns and outcomes of female patients with a primary diagnosis of nocturia who were seen at a tertiary referral centre in New York (USA). The predictive factors of therapeutic management failure were assessed.
A retrospective chart review of all new female patients seen in a single-centre functional urology practice with the diagnosis of nocturia was performed, and up to 3 visits within a 12-month period from the time of presenting were reviewed. The primary endpoint was patient-reported improvement assessed at each follow-up visit and the change in the number of nocturia episodes.
In all, 239 female patients were included for analysis, and the prevalence of nocturnal polyuria, reduced bladder capacity, and global polyuria were respectively 75%, 40.2%, and 18.1%. Within the first two visits, 72.7% of patients had started a treatment beyond behavioural therapies. Anticholinergics were the most commonly initiated treatment (47.2% of patients). 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). There was no statistically significant association between any of the bladder diary findings and treatment outcomes. 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).
Based on these data the authors conclude that whilst the prevalence of nocturnal polyuria in women with nocturia is high, the therapeutic management until 2016 relied mostly upon overactive bladder medications with a relatively low success rate.
This attitude was most probably highly influenced by the non-availability of any anti-diuretic medication at that time in the USA. It would interesting to see to which extent the launch of anti-diuretic medication indicated for patients with nocturia based on nocturnal polyuria changed the medical approach of nocturia.