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[Nocturia in men with benign prostatic hyperplasia].

Matthias Oelke1, Bernhard Fangmeyer1, Jörg Zinke1

  • 1Urologie, St. Antonius Hospital, Gronau.

Aktuelle Urologie
|August 8, 2018
PubMed
Summary
This summary is machine-generated.

Nocturia, a common symptom in men with benign prostatic hyperplasia (BPH), significantly impacts sleep and quality of life. Effective management involves identifying the cause and employing targeted treatments like desmopressin or alpha-blockers to reduce nighttime urination.

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Area of Science:

  • Urology
  • Men's Health
  • Lower Urinary Tract Symptoms

Background:

  • Nocturia, or waking to urinate at least once nightly, is a prevalent lower urinary tract symptom in men with benign prostatic hyperplasia (BPH).
  • This condition frequently leads to physician consultations due to its bothersome nature and association with increased morbidity and mortality.
  • Nocturia can stem from increased fluid intake, elevated diuresis, or diminished bladder capacity, often in combination.

Purpose of the Study:

  • To outline the diagnostic approach and treatment strategies for nocturia in men with BPH.
  • To emphasize the importance of identifying the underlying pathophysiology for effective management.
  • To highlight therapeutic options aimed at improving sleep quality and reducing nocturia frequency.

Main Methods:

  • Methodical patient evaluation is crucial for detecting the underlying pathophysiology of nocturia.
  • Three-day bladder diaries are an essential tool for assessing voiding patterns.
  • Diagnostic evaluation guides the selection of appropriate treatments based on the identified cause.

Main Results:

  • Treatment aims to reduce nocturnal voiding frequency to less than two episodes and enable over four hours of uninterrupted sleep.
  • Various treatments, including alpha-blockers, 5α-reductase inhibitors, PDE5 inhibitors, plant extracts, and surgery (e.g., TURP), are effective for reduced bladder capacity.
  • Nocturnal polyuria, present in up to 80% of BPH patients with nocturia, can be managed by reducing nighttime urine production, with desmopressin being a key option, especially low-dose formulations for older men.

Conclusions:

  • Accurate diagnosis of nocturia's cause in BPH patients is key to successful treatment.
  • Targeted therapies can significantly improve nocturia symptoms, sleep duration, and quality of life.
  • Combination therapies may be beneficial for patients with mixed nocturia pathophysiology.