Current Diagnosis and Treatment of Nocturia: UNI-MED SCIENCE

1. Definitions and Standardization of Terminology in Nocturia 14 2. Prevalence and Bother of Nocturia 18 2.1. Forewords of definition 18 2.2. Prevalence 19 2.3. Questionnaire versus frequency-volume chart in assessment of nocturia prevalence 20 2.4. Bother of nocturia 21 2.5. Conclusions 23 3. Pathophysiology of Nocturia 28 3.1. Urinary tract pathophysiology of nocturia 28 3.1.1. Renal causes of nocturia 28 3.1.2. Overactive bladder 29 3.1.3. Benign prostate enlargement 30 3.1.4. Neurogenic bladder 31 3.1.5. Bladder pain syndrome 31 3.1.6. Differential diagnosis 32 3.1.7. Conclusions 32 3.2. Nocturia and heart diseases 35 3.2.1. Pathophysiology of nocturia in heart failure 35 3.2.2. Management of heart failure 41 3.2.3. Summary 43 3.3. Nocturia and pulmonary diseases 45 3.3.1. Association of nocturia and pulmonary disease 45 3.3.2. Pulmonary hypertension 45 3.3.3. Pulmonary mechanisms causing nocturia 45 3.3.4. Pulmonary diseases associated with nocturia 46 3.3.5. Summary 52 4. Impact of Nocturia on Sleep and Quality of Life 56 4.1. Impact of nocturia on Quality of Sleep 56 4.1.1. Normal sleep 56 4.1.2. Sleep, how much is enough? 56 4.1.3. Sleep and age 57 4.1.4. Insights into the consequences of sleep disturbance: proof from nocturia 58 4.1.5. Conclusions 60 4.2. Nocturia and impact on Quality of Life 62 4.2.1. Definition of Health-Related Quality of Life (HRQoL) 62 4.2.2. HRQoL - The need for a reliable and valid instrument 62 4.2.3. Disease-specific vs. generic questionnaires 63 4.2.4. Is QoL worth assessing? 63 4.2.5. QoL and nocturia 64 4.2.6. Conclusion 68 5. Assessment of Nocturia and Nocturnal Polyuria 72 5.1. Nocturnal polyuria 73 5.2. Decreased nocturnal bladder capacity 74 5.3. Mixed nocturia 75 5.4. Global polyuria 75 6. Management of Nocturia and Treatment Algorithms 80 6.1. Behavioural strategies 80 6.2. Therapy for concomitant (non-urological) disorders 81 6.3. Treatment of sleep disorders 81 6.4. Pharmacological therapy for urological disorders 81 6.4.1. Targeting the bladder or prostate 81 6.4.2. Targeting the kidney - antidiuretic therapy 82 6.4.3. Gender differences during desmopressin treatment 85 6.4.4. Combination therapy 85 6.5. Prostate surgery 86 6.6. Patient-related benefits of nocturia therapy 86 6.7. Conclusions 87 7. Outlook - Future Developments in the Treatment of Nocturia 92 7.1. The impact of definitions 92 7.2. How do we measure nocturia and its impact? 92 7.3. One symptom - many causes 93 7.4. What are meaningful treatment goals? 93 7.5. Future treatments 94 Index 95