Clinical Review

Managing nocturia

BMJ 2004; 328 doi: http://dx.doi.org/10.1136/bmj.328.7447.1063 (Published 29 April 2004) Cite this as: BMJ 2004;328:1063
  1. Serge P Marinkovic (Serge1127@yahoo.com), urogynaecologist1,
  2. Lisa M Gillen, medical writer2,
  3. Stuart L Stanton, emeritus professor of urogynaecology, St George's Hospital Medical School3
  1. Division of Urology, Southern Illinois School of Medicine, Suite 2500, 1800 East Lakeshore Road, Decatur, IL 62521, USA
  2. St Mary's Hospital, Department of Urology, Decatur, IL 62521, USA
  3. 43 Wimpole Street, Flat 10, London W1G 8AE
  1. Correspondence to: S P Marinkovic
  • Accepted 9 March 2004

Introduction

Nocturia, or frequent urination at night time, is a common but poorly reported and largely misunderstood urological disorder in adults.1 2 Although many people awaken during the night to urinate, the condition has received little attention in the medical literature, and definitions vary widely. The International Continence Society defines nocturia as two or more night time voids. In its simplest terms, nocturia refers to urination at night and entails some degree of impairment, with urinary frequency often considered excessive and disruptive. However, excessive urination may refer to either the volume of urine voided or the number of trips to the toilet, as normal frequency and volume for nocturnal urination have been poorly defined among all age groups.3 4 With no accepted distinction between normal and abnormal urination, doctors tend to overlook nocturia as a possible source of medical problems associated with the resultant loss of sleep, and patients tend not to report the condition to their doctors until it becomes unbearable or their quality of life during daytime hours is severely compromised.5 Nocturia has a role in numerous aspects of people's health and wellbeing, contributing to fatigue, memory deficits, depression, increased risk of heart disease, gastrointestinal disorders, and, at times, traumatic injury through falls. Adequate, restful sleep is important to everyone, regardless of age. Our entire way of life, our health, happiness, and ability to function at home and at work suffer from inadequate rest. Evidently nocturia is more complex and important a condition than recognised so far. Identifying nocturia, determining its causes, and treating it effectively are keys to improving patients' quality of life.

Fig 1

Algorithm for the definition and treatment of nocturia

Sources

We searched Medline for 1980-2003 by using the key words “nocturia” and “nocturnal polyuria.” We selected 22 references for this review.

Causes

In general nocturia …

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