A recent update in International Continence Society (ICS) terminology now recognizes nocturnal polyuria (NP) and diurnal polyuria (DP) as related subcategories of "Polyuria (global symptom)". This study determines the real-world clinical overlap between NP, DP, and 24-h polyuria (24hP) among men with nocturia.
Analysis of frequency-volume charts from men ≥ 18 years with ≥ 1 nocturnal void(s). Three separate analyses were performed using different rate criteria for NP, DP, and 24hP: (1) urine production > 90 mL/h (extrapolated from a proposed definition for NP); (2) > 125 mL/h (extrapolated from a proposed definition for 24hP [3000 mL/24 h]); and (3) > 1.67 mL/kg/h (extrapolated from the current ICS definition for 24hP [> 40 mL/kg/24 h]). Subjects were categorized as having one of five mathematically permissible phenotypic combinations: (1) isolated NP, (2) isolated DP, (3) NP + 24hP, (4) DP + 24hP, and (5) NP + DP + 24hP.
167, 95, and 61 patients were included at criteria 1, 2, and 3, respectively, with 56%, 43%, and 30% of patients demonstrating overlapping phenotypes (i.e., phenotypic combinations 3-5) at cut-offs 1-3, respectively. The prevalence of NP was similar across cut-offs (81-87%), but the prevalence of NP without 24hP was highly threshold-dependent (43-73%).
Consistent with current ICS terminology, there exists a substantial overlap between NP, DP, and 24hP. As demonstrated in the current study, absolute volume-based criteria for NP/DP/24hP are indeed conducive to the diagnosis of concurrent NP + 24hP, and may be preferred over proportion-based NP criteria when both NP + 24hP are suspected.
International urology and nephrology. 2020 May 20 [Epub ahead of print]
Thomas F Monaghan, Syed N Rahman, Connelly D Miller, Christina W Agudelo, Kyle P Michelson, Nelson A Nwannunu, Jason M Lazar, Donald L Bliwise, Joseph G Verbalis, Karel Everaert, Jerry G Blaivas, Alan J Wein, Jeffrey P Weiss
Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA. ., Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA., Division of Cardiovascular Medicine, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA., Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA., Division of Endocrinology and Metabolism, Department of Medicine, Georgetown University Medical Center, Washington, DC, USA., Department of Urology, Ghent University Hospital, Ghent, Belgium., Division of Urology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.