Department of Urology, Päijät-Häme Central Hospital, Lahti, Finland; Department of Urology, Tampere University Hospital and Medical School, University of Tampere, Tampere, Finland.
Department of Epidemiology and Biostatistics, Imperial College London, London, UK; Department of Urogynaecology, Imperial College London, London, UK.
Eur Urol. 2016 Aug;70(2):372-81. doi: 10.1016/j.eururo.2016.02.014. Epub 2016 Feb 20.
Although vital for decision-making about management, the natural history of nocturia remains uncertain. A systematic review would clarify the issue, but because natural history reviews are uncommon it would require methodological innovations.
To estimate the incidence and remission of nocturia, and refine methods for meta-analyses assessing natural history.
We conducted a comprehensive search of PubMed, Scopus, and Cumulative Index of Nursing and Allied Health Literature databases and abstracts of major urologic meetings as far as August 31, 2015. Random effects meta-analyses addressed incidence/remission rates of nocturia; meta-regression explored potential determinants of heterogeneity. Studies were categorized as either low or high risk of bias using a novel instrument specifically designed for longitudinal symptom studies aimed at the general population.
Of 4165 potentially relevant reports, 16 proved eligible. Pooled estimates from 13 studies (114 964 person-years of follow-up) demonstrated that annual incidence was strongly associated with age: 0.4% (0-0.8%) for adults aged < 40 yr; 2.8% (1.9-3.7%) for adults aged 40-59 yr; and 11.5% (9.1-14.0%) for adults aged ≥ 60 yr. Of those with nocturia, each year 12.1% (9.5-14.7%) experienced remission.
The available evidence suggests that nocturia onset is strongly associated with age, with much higher rates in those over 60 yr; remission occurs in approximately 12% each year. These estimates can aid with management decisions and counseling related to nocturia.
We reviewed all previous studies of progression of night-time urination (nocturia). We found that in any given year 0.4% of adults aged < 40 yr, 3% of adults aged 40-59 yr, and 12% of adults aged ≥ 60 yr will develop nocturia, while overall 12% of those with nocturia will improve. These findings may be helpful in making decisions about coping with or treating nocturia.
尽管对于管理决策至关重要，但夜尿症的自然史仍不确定。系统评价将澄清这一问题，但由于自然史评价不常见，因此需要创新方法。
估计夜尿症的发生率和缓解率，并改进评估自然史的荟萃分析方法。
我们对 PubMed、Scopus 和 Cumulative Index of Nursing and Allied Health Literature 数据库进行了全面检索，并检索了截至 2015 年 8 月 31 日的主要泌尿科会议的摘要。随机效应荟萃分析解决了夜尿症的发生率/缓解率；荟萃回归探讨了异质性的潜在决定因素。使用专门为针对普通人群的纵向症状研究设计的新型仪器对研究进行分类，分为低风险或高风险偏倚。
在 4165 篇可能相关的报告中，有 16 篇被证明符合条件。来自 13 项研究（114964 人年的随访）的汇总估计表明，年发生率与年龄密切相关：<40 岁的成年人发生率为 0.4%（0-0.8%）；40-59 岁的成年人发生率为 2.8%（1.9-3.7%）；≥60 岁的成年人发生率为 11.5%（9.1-14.0%）。在患有夜尿症的患者中，每年有 12.1%（9.5-14.7%）缓解。
现有证据表明，夜尿症的发生与年龄密切相关，60 岁以上人群的发生率更高；每年约有 12%的患者缓解。这些估计可以帮助做出与夜尿症相关的管理决策和咨询。
我们回顾了所有关于夜间排尿（夜尿症）进展的先前研究。我们发现，在任何一年中，<40 岁的成年人中有 0.4%、40-59 岁的成年人中有 3%、≥60 岁的成年人中有 12%会出现夜尿症，而总体上有 12%的夜尿症患者会得到改善。这些发现可能有助于做出应对或治疗夜尿症的决策。
