Evaluation and treatment in urology for nocturia caused by nonurological mechanisms: guidance from the PLANET study
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Published version
Author(s)
Type
Journal Article
Abstract
Patients with nocturia are commonly referred to urology clinics, including many for whom a nonurological medical condition is responsible for their symptoms. The PLanning Appropriate Nocturia Evaluation and Treatment (PLANET) study was established to develop practical approaches to equip healthcare practitioners to deal with the diverse causes of nocturia, based on systematic reviews and expert consensus. Initial assessment and therapy need to consider the possibility of one or more medical conditions falling into the “SCREeN” areas of Sleep medicine (insomnia, periodic limb movements of sleep, parasomnias, and obstructive sleep apnoea), Cardiovascular (hypertension and congestive heart failure), Renal (chronic kidney disease), Endocrine (diabetes mellitus, thyroid disease, pregnancy/menopause, and diabetes insipidus), and Neurology. Medical and medication causes of xerostomia should also be considered. Some key indicators for these conditions can be identified in urology clinics, working in partnership with the primary care provider. Therapy of the medical condition in some circumstances lessens the severity of nocturia. However, in many cases there is a conflict between the two, in which case the medical condition generally takes priority on safety grounds. It is important to provide patients with a realistic expectation of therapy and awareness of limitations of current therapeutic options for nocturia.Patient summaryNocturia is the symptom of waking at night to pass urine. Commonly, this problem is referred to urology clinics. However, in some cases, the patient does not have a urological condition but actually a condition from a different speciality of medicine. This article describes how best the urologist and the primary care doctor can work together to assess the situation and make sensible and safe treatment suggestions. Unfortunately, there is sometimes no safe or effective treatment choice for nocturia, and treatment needs to focus instead on supportive management of symptoms.
Date Issued
2022-01
Date Acceptance
2022-01-07
Citation
European Urology Focus, 2022, 8 (1), pp.89-97
ISSN
2405-4569
Publisher
Elsevier
Start Page
89
End Page
97
Journal / Book Title
European Urology Focus
Volume
8
Issue
1
Copyright Statement
© 2022 The Authors. Published by Elsevier B.V. on behalf of European Association of Urology. This is an open access article
under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Identifier
https://www.eu-focus.europeanurology.com/article/S2405-4569(22)00007-4/fulltext
Notes
Funding Information: Funding/Support and role of the sponsor: This project is funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number NIHR RfPB PB-PG-1217-20034). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. Funding Information: Financial disclosures: Marcus J. Drake certifies that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg, employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: Sofia H. Eriksson is supported in part by the National Institute for Health Research University College London Hospitals Biomedical Research Centre funding scheme. Marcus J. Drake is an advisory board member for Ferring, and a speaker for Astellas and Pfizer. Publisher Copyright: © 2022 The Authors keywords: Nocturia, Lower urinary tract symptoms, Obstructive sleep apnoea, Chronic kidney disease, Hypertension, Insomnia, Diabetes mellitus
Publication Status
Published
Date Publish Online
2022-01-28