Current Diagnosis and Treatment of Nocturia

1.Definitions and Standardization of Terminology in Nocturia14
2.Prevalence and Bother of Nocturia18
2.1.Forewords of definition18
2.2.Prevalence19
2.3.Questionnaire versus frequency-volume chart in assessment of nocturia prevalence20
2.4.Bother of nocturia21
2.5.Conclusions23
3.Pathophysiology of Nocturia28
3.1.Urinary tract pathophysiology of nocturia28
3.1.1.Renal causes of nocturia28
3.1.2.Overactive bladder29
3.1.3.Benign prostate enlargement30
3.1.4.Neurogenic bladder31
3.1.5.Bladder pain syndrome31
3.1.6.Differential diagnosis32
3.1.7.Conclusions32
3.2.Nocturia and heart diseases35
3.2.1.Pathophysiology of nocturia in heart failure35
3.2.2.Management of heart failure41
3.2.3.Summary43
3.3.Nocturia and pulmonary diseases45
3.3.1.Association of nocturia and pulmonary disease45
3.3.2.Pulmonary hypertension45
3.3.3.Pulmonary mechanisms causing nocturia45
3.3.4.Pulmonary diseases associated with nocturia46
3.3.5.Summary52
4.Impact of Nocturia on Sleep and Quality of Life56
4.1.Impact of nocturia on Quality of Sleep56
4.1.1.Normal sleep56
4.1.2.Sleep, how much is enough?56
4.1.3.Sleep and age57
4.1.4.Insights into the consequences of sleep disturbance: proof from nocturia58
4.1.5.Conclusions60
4.2.Nocturia and impact on Quality of Life62
4.2.1.Definition of Health-Related Quality of Life (HRQoL)62
4.2.2.HRQoL – The need for a reliable and valid instrument62
4.2.3.Disease-specific vs. generic questionnaires63
4.2.4.Is QoL worth assessing?63
4.2.5.QoL and nocturia64
4.2.6.Conclusion68
5.Assessment of Nocturia and Nocturnal Polyuria72
5.1.Nocturnal polyuria73
5.2.Decreased nocturnal bladder capacity74
5.3.Mixed nocturia75
5.4.Global polyuria75
6.Management of Nocturia and Treatment Algorithms80
6.1.Behavioural strategies80
6.2.Therapy for concomitant (non-urological) disorders81
6.3.Treatment of sleep disorders81
6.4.Pharmacological therapy for urological disorders81
6.4.1.Targeting the bladder or prostate81
6.4.2.Targeting the kidney – antidiuretic therapy82
6.4.3.Gender differences during desmopressin treatment85
6.4.4.Combination therapy85
6.5.Prostate surgery86
6.6.Patient-related benefits of nocturia therapy86
6.7.Conclusions87
7.Outlook – Future Developments in the Treatment of Nocturia92
7.1.The impact of definitions92
7.2.How do we measure nocturia and its impact?92
7.3.One symptom – many causes93
7.4.What are meaningful treatment goals?93
7.5.Future treatments94
Index95