AUA 2018: Clinical Evaluation and Treatment of Nocturia is Modest at Best

San Francisco, CA (UroToday.com)  According to Dr. Drangsholt, nocturia was defined as one or more voids at night. Primary purpose of the study was to analyze diagnostic processes and effectiveness of clinical treatment options available.   Researchers conducted a chart review of patients with a new diagnosis of nocturia from 2010 to 2016. Data on all eligible subjects were collected within a year after the first encounter. Out of all patients who were considered eligible for the study, 52% of individuals have reported previous pharmacotherapy. Voiding diary (FVC) was prescribed to half of the study participants, but patient compliance with the FVC was only at 63%.  



Polyuria and overactive bladder were the most common types of urinary dysfunctions classified by analyzing full voiding charts. Some subjects were recommended medications, but less than half of these participants reported some improvement of their symptoms. These data were compared to patients who didn’t complete a voiding diary, and there was no significant difference in terms of improvement.  

49% of new encounters were prescribed multifactorial treatment including behavioral modifications, medications, and referral to the sleep specialist to address probable underlying issues. However, only half of patients who were recommended multiple treatment options and decided to comply, have reported improvement of their symptoms. Although analysis of FVC revealed high percentage of patients with polyuria, desmopressin (DDAVP) was prescribed for mere 5% of patients (Figure 1). 

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This study is important because it can inform future researchers about shortcomings of currently available techniques. Results show that current diagnostic practices and available nocturia treatment options are not sufficient for improvement of patients’ symptoms and quality of life. FVC serves as a great tool, but its’ accuracy depends on patients compliance with completing a diary, and it’s not correlated with patient reported improvement. In terms of pharmaceutical treatments, DDAVP was rarely prescribed due to patients failing other therapies for the overactive bladder symptoms.  

Presented by: Siri Drangsholt, MD, New York University School of Medicine, New York. 
Co-authors: Maria Arcila Ruiz, MD; Victor Nitti, MD; Nirit Rosenblum, MD; Benjamin Brucker, MD 

Written by: Hanna Stambakio, BS, Clinical Research Coordinator, Division of Urology, University of Pennsylvania Twitter: @PennUrology at the 2018 AUA Annual Meeting - May 18 - 21, 2018 – San Francisco, CA USA

Watch a Video Presentation on this Study by Benjamin Brucker, MD
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