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 SUMMARY: Nocturia 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.
European urology focus. 2022 Jan 28 [Epub ahead of print]
Matthew Smith, Shoba Dawson, Robert C Andrews, Sofia H Eriksson, Hugh Selsick, Andrew Skyrme-Jones, Udaya Udayaraj, Jonathan Rees, Edward Strong, Emily J Henderson, Marcus J Drake
Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK., Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK., Department of Clinical and Experiential Epilepsy, UCL Institute of Neurology, University College London, London, UK., Insomnia and Behavioural Sleep Medicine, University College London Hospitals, London, UK., Cardiology Department, Southmead Hospital, North Bristol NHS Trust, Bristol, UK., Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, UK; Oxford Kidney Unit, Churchill Hospital, Oxford, UK., Tyntesfield Medical Group, North Somerset, UK., Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Older People's Unit, Royal United Hospital NHS Foundation Trust, Bath, UK., Bristol Urological Institute, North Bristol NHS Trust, Bristol, UK; Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK. Electronic address: .