Nocturnal polyuria (NP) and global polyuria (GP) are not mutually exclusive. However, by rate, the common criteria for GP (40 mL/kg/24 hours [117 mL/kg/hour in a 70-kg individual] or 3000 mL/24 hours [125 mL/h]) are more stringent than those for NP (90 mL/hour during the sleep period or NP index [NPi; nocturnal volume/24-hour volume] > 0. 33 [no minimum rate]). It remains unclear whether total nocturnal urine volume (NUV) may reliably delineate between NP patients with and without comorbid GP.
A clinical database of men with lower urinary tract symptoms was searched for voiding diaries completed by patients reporting greater than or equal to 1 nocturnal void(s). Four separate analyses were performed using all combinations of the two NP and two GP criteria listed above. For each analysis, patients were included if they met the criteria for NP, and then stratified by presence or absence of GP (ie, NP + GP vs isolated NP).
Median NUV was greater among patients with NP + GP for all criteria combinations. Sensitivities greater than or equal to 80%/90%/100% for NP + GP were observed at 1275/1230/1085 mL for {NPi > 0.33 + 24-hour volume > 3000 mL}; 1075/1035/1035 mL for {NPi > 0.33 + 24-hour volume > 40 mL/kg}; 900/745/630 mL for {NUP > 90 mL/hour + 24-hour volume > 3000 mL}; and 1074/1035/990 mL for {NUP > 90 mL/hour + 24-hour volume > 40 mL/kg}.
An inordinate NUV among men with NP is fairly sensitive for comorbid GP. In the appropriate clinical setting, nocturnal-only diaries may suffice in the evaluation and follow-up of patients with NP, so long as outlying nocturnal volumes prompt a 24-hour diary/urine collection.
Neurourology and urodynamics. 2019 Nov 06 [Epub ahead of print]
Thomas F Monaghan, Syed N Rahman, Donald L Bliwise, Kyle P Michelson, Christina W Agudelo, Connelly D Miller, Corey S Weinstein, Tine K Olesen, Jason M Lazar, Karel Everaert, Joseph G Verbalis, Jeffrey P Weiss
Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, New York., Department of Neurology, Emory University School of Medicine, Atlanta, Georgia., Department of Urogynaecology, Ghent University Hospital, Ghent, Belgium., Department of Medicine, Division of Cardiovascular Medicine, State University of New York Downstate Health Sciences University, Brooklyn, New York., Department of Urology, Ghent University Hospital, Ghent, Belgium., Department of Medicine, Division of Endocrinology and Metabolism, Georgetown University Medical Center, Washington, District of Columbia.