Department of Urology, SUNY Downstate College of Medicine, 450 Clarkson Avenue, Box 79, Brooklyn, NY, 11203, USA.
Curr Urol Rep. 2019 Nov 9;20(11):75. doi: 10.1007/s11934-019-0940-2.
Nocturia is defined as awakening due to the desire to void during a period of intended sleep. The pathophysiology of nocturia is multifactorial and management remains a challenge. Herein, we provide an overview of the management strategies for nocturia and summarize the existing evidence for treatment of nocturia across the condition's broad etiologic categories: nocturnal polyuria, diminished bladder capacity, and global polyuria.
Treatment should begin with behavioral modification. A high level of evidence supports the efficacy of desmopressin in the treatment of nocturnal polyuria. Data supporting the efficacy of α-blockers, antimuscarinics, and surgical bladder outlet procedures in the treatment of nocturia remains limited. Treatment options for nocturia are determined by underlying mechanism. Desmopressin is effective in treating nocturnal polyuria. Surgical intervention, α-blockers, and antimuscarinics may improve nocturia when associated with lower urinary tract symptoms or overactive bladder in the setting of diminished bladder capacity.
夜尿症是指在睡眠期间因排尿欲望而醒来。夜尿症的病理生理学是多因素的,其管理仍然是一个挑战。本文概述了夜尿症的管理策略,并总结了治疗夜尿症的现有证据,这些证据涵盖了夜尿症广泛的病因类别:夜间多尿、膀胱容量减少和全身性多尿。
治疗应从行为改变开始。大量证据支持去氨加压素治疗夜间多尿的疗效。支持α受体阻滞剂、抗胆碱能药物和手术膀胱出口治疗夜尿症的疗效的数据仍然有限。夜尿症的治疗选择取决于潜在的机制。去氨加压素治疗夜间多尿有效。当与膀胱容量减少相关的下尿路症状或逼尿肌过度活动时,手术干预、α受体阻滞剂和抗胆碱能药物可能改善夜尿症。