A contemporary assessment of nocturia: definition, epidemiology, pathophysiology, and management--a systematic review and meta-analysis

Autor: Martin C. Michel, Andrea Tubaro, Christopher R. Chapple, Paul Abrams, Gary E. Lemack, Jean-Nicolas Cornu, Roger R. Dmochowski, Stephan Madersbacher
Jazyk: angličtina
Rok vydání: 2012
Předmět:
Male
desmopressin
Pathology
Anti-Inflammatory Agents
Cochrane Library
urologic and male genital diseases
law.invention
systematic review
Randomized controlled trial
Risk Factors
law
Epidemiology
Odds Ratio
Prevalence
a1-blockers
Desmopressin
alpha(1)-blockers
antimuscarinics
meta-analysis
nocturia
nocturnal polyuria
α1-blockers
Evidence-Based Medicine
Antidiuretic Agents
Diagnostic Techniques
Urological
Middle Aged
Pathophysiology
female genital diseases and pregnancy complications
Treatment Outcome
Meta-analysis
Urologic Surgical Procedures
Female
Nocturia
medicine.symptom
medicine.drug
medicine.medical_specialty
Urology
MEDLINE
Muscarinic Antagonists
Predictive Value of Tests
Internal medicine
medicine
Humans
Intensive care medicine
Aged
Chi-Square Distribution
business.industry
Evidence-based medicine
Clinical trial
Urodynamics
Endocrinology
Adrenergic alpha-1 Receptor Antagonists
business
Zdroj: European urology. 62(5):877-890
ISSN: 0302-2838
DOI: 10.1016/j.eururo.2012.07.004
Popis: Context Nocturia is a common urologic symptom that has been covered in a variety of reported studies in the literature but is not specifically covered in current guidelines. Objective To comprehensively review the literature pertaining to the definition, etiologies, and consequences of nocturia and assess the evidence supporting the use of conservative medical and interventional therapy. Evidence acquisition A literature search was conducted using the keyword nocturia , restricted to articles in the English language, after 2000 and before April 2012, in PubMed/Medline, Embase, Scopus, Web of Science, and Cochrane Library databases. Regarding treatment modalities, studies were included only if nocturia was a primary end point and if the studies were designed as randomized controlled trials without limit of date. When suitable, a meta-analysis was conducted. Papers covering treatment options for nocturia specifically related to nonurologic conditions were excluded. Evidence synthesis Nocturia is still defined as the symptom of wakening from sleep once or more often to void. The prevalence is high in both genders and increases with age. Frequency–volume charts, which are the pivotal tool of clinical assessment, detect 24-h polyuria, nocturnal polyuria (NP), or reduced nocturnal bladder capacity and help to target specific nonurologic etiologies. Nocturia is a morbid condition that significantly affects quality of life and increases mortality. Besides behavioral measures, validated treatment options include oral desmopressin, which is superior to placebo in treating NP. While the level of evidence for desmopressin is high, limited data support the use of α 1 -blockers and antimuscarinics; however, only rarely has nocturia been a primary end point when studying these drug classes, and studies have not consistently controlled for the effect of NP. Conclusions Our knowledge of nocturia, its etiology, and its management has substantially improved in recent years. The evidence available on the management of nocturia remains limited; contributory factors include (1) the complexity of associated conditions, (2) the underuse of objective evaluation tools, and (3) the lack of specific focus on nocturia in clinical trials.
Databáze: OpenAIRE
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