Nocturia is a complex condition that not only significantly affects quality of life, but may be an indicator of systemic disease. Initial assessment includes a detailed history and physical examination and completion of a frequency volume chart to help identify underlying causes, such as sleep disorders, bladder storage disorders, and polyuria. Treatment with alpha-blockers or antimuscarinic medications may help if the underlying cause is determined to be benign prostatic hyperplasia or overactive bladder, respectively. Treatment options for nocturnal polyuria have been limited to behavioral therapy and off-label use of timed diuretics and desmopressin. Desmopressin acetate nasal spray (Noctiva™, Avadel Pharmaceuticals, Chesterfield, MO) was approved by the US Food and Drug Administration in 2017 for the treatment of nocturia due to nocturnal polyuria in adults who awaken at least twice nightly and has shown efficacy in reducing nocturnal voids by ≥50% in up to 49% of patients in clinical trials.
Reviews in urology. 2018 Jan [Epub]
Casey G Kowalik, Joshua A Cohn, Sophia Delpe, W Stuart Reynolds, Melissa R Kaufman, Doug F Milam, Alan J Wein, Roger R Dmochowski
Department of Urologic Surgery, Vanderbilt University Medical Center Nashville, TN., Department of Urology, Einstein Healthcare Network Philadelphia, PA., Division of Urology, Hospital of the University of Pennsylvania Philadelphia, PA.