title: Pitfalls and opportunities in multidisciplinary research about nocturia in adults.
abstract: OBJECTIVE
  Describe current shortcomings in clinical research on the treatment of nocturia in adults, and suggest new directions for future studies in this field.
  
  
  METHODS
  A literature search was conducted using the keywords 'nocturia,' 'nocturnal polyuria,' 'sleep,' and 'hypertension.'
  
  
  RESULTS
  Nocturia, or waking up at night to void, is a highly prevalent and bothersome lower urinary tract symptom (LUTS) affecting up to 40% of adults. Since the majority of patients are diagnosed with nocturnal polyuria (NP) as one of the underlying causes, it is not surprising that the effect of treatments for overactive bladder (OAB) and bladder outlet obstruction (BOO) are disappointing with regard to nocturia. Therefore, we suggest to conduct studies in which nocturic patients are treated according to the underlying pathophysiology: (1) antimuscarinics or β3-agonists for OAB symptoms, (2) α-blockers or 5α-reductase inhibitors in men with BOO caused by enlarged prostates, (3) desmopressin or diuretics for NP, (4) continuous positive airway pressure in nocturic patients with obstructive sleep apnea, and (5) all its combinations in case of combined pathophysiology. Not only the effect on treatment efficacy or side effects needs to be assessed, but also the impact on related comorbidities such as sleep disorders, hypertension, and endocrine functions such as blood glucose regulation.
  
  
  CONCLUSIONS
  Future research needs to subtype nocturic patients in order to adapt treatment according to the underlying cause.
authors.affiliation: a Department of Urology , Ghent University Hospital , Ghent , Belgium.
authors.forename: Marie-Astrid
authors.initials: MA
authors.lastname: Denys
authors.affiliation: a Department of Urology , Ghent University Hospital , Ghent , Belgium.
authors.forename: Elke
authors.initials: E
authors.lastname: Bruneel
authors.affiliation: b Department of Nephrology , Ghent University Hospital , Ghent , Belgium.
authors.forename: Steven
authors.initials: S
authors.lastname: Van Laecke
authors.affiliation: c Ferring, Global Scientific Affairs Urology , Ferring International PharmaScience Centre , Copenhagen , Denmark.
authors.forename: Jens Peter
authors.initials: JP
authors.lastname: Nørgaard
authors.affiliation: a Department of Urology , Ghent University Hospital , Ghent , Belgium.
authors.forename: Karel
authors.initials: K
authors.lastname: Everaert
mesh_terms: D050034:Antidiuretic Agents / Q000627:therapeutic use*; D002985:Clinical Protocols; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use*; D004232:Diuretics / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000150:complications; D033183:Interdisciplinary Communication; D053158:Nocturia / Q000188:drug therapy* / Q000209:etiology; D012892:Sleep Deprivation / Q000209:etiology
chemical_list: D050034:Antidiuretic Agents; D004232:Diuretics; D003894:Deamino Arginine Vasopressin
keywords: Hypertension; Nocturia; Nocturnal polyuria; Pathophysiology; Sleep