title: A contemporary assessment of nocturia: definition, epidemiology, pathophysiology, and management--a systematic review and meta-analysis.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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 α1-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.
authors: Department of Urology, Tenon Hospital, University Paris 6, Assistance Publique-Hopitaux de Paris, Paris, France. jeannicolas.cornu@gmail.com
authors: Jean-Nicolas
authors: JN
authors: Cornu
authors: Paul
authors: P
authors: Abrams
authors: Christopher R
authors: CR
authors: Chapple
authors: Roger R
authors: RR
authors: Dmochowski
authors: Gary E
authors: GE
authors: Lemack
authors: Martin C
authors: MC
authors: Michel
authors: Andrea
authors: A
authors: Tubaro
authors: Stephan
authors: S
authors: Madersbacher
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D050034:Antidiuretic Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D003950:Diagnostic Techniques, Urological; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D053158:Nocturia / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D016896:Treatment Outcome; D014563:Urodynamics; D013520:Urologic Surgical Procedures
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D000893:Anti-Inflammatory Agents; D050034:Antidiuretic Agents; D018727:Muscarinic Antagonists