Nocturia is usually considered to be just one of the symptoms included with
lower urinary tract symptoms (LUTS) and is treated with
therapy based on LUTS. Recent research suggests, however, that
nocturia is not merely a simple symptom of LUTS but is a multifactorial condition with many contributing etiological factors. The causes of
nocturia can be classified into bladder storage problems, increased urine output, sleep disturbance problems, and other potential diseases. The frequency-volume chart (FVC) is very important in evaluating and diagnosing
nocturia. Patients usually record the volume and timing of voids for a period of 1 to 3 days on the FVC. The FVC data can provide information on voiding patterns and clues about the etiology and treatment of
nocturia. It is doubtful that alpha-blockers will have clinical significance for treatment because the difference in
nocturia episodes between treatment with alpha-blockers and placebo is too small.
Antimuscarinics also exert no effect on nocturnal
polyuria, and the evidence supporting the efficacy of
antimuscarinics for the treatment of
nocturia is limited. However, several randomized placebo-controlled trials have shown the efficacy of oral
desmopressin in the treatment of adults with
nocturia. Short-acting
hypnotics may be helpful for patients with sleep disturbances. Although surgical or interventional
therapy is not indicated for
nocturia, transurethral resection of the prostate appears to confer a greater improvement in
benign prostatic hyperplasia symptoms including
nocturia. The management of
nocturia may require a team approach by making optimal use of multidisciplinary expertise.