Nocturia is one of the commonest nonmotor symptoms in Parkinson's disease (PD) and has a significant impact on quality of life both for patients and their carers. There exists a relation between nocturia and poor sleep quality, falls, and institutionalization. Nocturia may manifest as a result of reduced functional bladder capacity or nocturnal polyuria; however, most often the cause is multifactorial. Disorders of circadian rhythm regulation are known to occur with sleep disturbances in PD may also contribute to nocturia.
In this review, an overview of the assessment and management of nocturia in patients with PD is presented. History taking, medication review, and a bladder diary form the cornerstone of the evaluation. Urinalysis, ultrasonography, and urodynamic studies help to assess the cause for lower urinary tract symptoms and exclude concomitant pathologies, such as bladder outlet obstruction. Antimuscarinic medications are the first-line treatment for the overactive bladder; however, caution is needed when using these medications in individuals predisposed to cognitive impairment. Desmopressin is effective for managing nocturnal polyuria.
An individualized approach is recommended to optimize the management of nocturia in PD.
Movement disorders clinical practice. 2016 Jun 07*** epublish ***
Amit Batla, Véronique Phé, Lorenzo De Min, Jalesh N Panicker
Department of Motor neuroscience and Movement Disorders UCL Institute of Neurology London United Kingdom., Department of Uro-Neurology The National Hospital for Neurology and Neurosurgery and UCL Institute of Neurology London United Kingdom.