Abstract
Objective: To identify pathophysiological mechanisms of nocturia and the
correlation of these mechanisms with nocturia severity. Methodology:
After approval by the local ethics committee, all patients with nocturia
(≥1 nocturnal void/night) were included and filled the overactive
bladder questionnaire (OABq), nocturia quality of life (N-QoL),
ICIQ-MLUTS (male), ICIQ-FLUTS (female) and 3-day frequency-volume chart.
Patients were divided into three groups according the severity of
nocturia: group 1 consisted of patients with mild (1-2 voids/night),
group 2 with moderate (3-4 voids/night) and group 3 with severe nocturia
(>4 voids/night). Comparative analysis were performed
between groups, p<0.05 was deemed as statistically
significant. Results: 68.1%, 64.1% and 8.7% of the patients had
nocturnal polyuria, reduced bladder capacity and global polyuria;
respectively. 42.7% of the patients had mixed nocturia. 6.1% of the
patients did not comply with the afore-mentioned subtypes and defined as
isolated nocturia. Regarding the severity of nocturia; 155 (41%)
patients had mild, 167 (45%) patients had moderate and 57 (15%)
patients had severe nocturia. Increased nocturia severity was related
with decreased quality of life; higher age, urinary tract symptom
scores, nocturnal urine volume, evening fluid consumption and
beta-blocker medication rates. Increased nocturia severity was also
associated with higher nocturnal polyuria, global polyuria and reduced
bladder capacity rates. Conclusions: Nocturia mechanisms may vary
between mild and moderate to severe nocturia groups according to the
present study. Nocturia grading with identification of subtypes may help
for better standardization of the diagnostic and treatment approaches as
well as for the design of future clinical trials.