The pilot study was conducted only on men. Diagnosis
Nocturia diagnosis requires knowing the patients nocturnal urine volume (NUV). The ICS defines NUV as “the total volume of urine passed between the time the individual goes to bed with the intention of sleeping and the time of waking with the intention of rising.” Thus, NUV excludes the last void before going to bed, but includes the first morning void if the urge to urinate woke the patient. The amount of sleep a patient gets, and the amount they intend to get, are also considered in a diagnosis.As with any patient, a detailed history of the problem is required to establish what is normal for that patient. The principal diagnostic tool for nocturia is the voiding bladder diary. Based on information recorded in the diary, a physician can classify the patient as having global polyuria, nocturnal polyuria, or bladder storage problems. A voiding bladder diary should record:
number of voids
timing of voids
volume voided
volume and time of fluid intakePatients should include the first morning void in the NUV. However, the first morning void is not included with the number of nightly voids. Causes
Polyuria
Polyuria is excessive or an abnormally large production or passage of urine. Increased production and passage of urine may also be termed diuresis. Polyuria is usually viewed as a symptom or sign of another disorder (not a disease by itself), but it can be classed as a disorder, at least when its underlying causes are not clear.
Fluid restriction does not help people who have nocturia due to gravity-induced third spacing of fluid because fluid is mobilized when they lie in a reclining position. Compression stockings may be worn through the day to prevent fluid from accumulating in the legs, unless heart failure or another contraindication is present. Drugs that increase the passing of urine can help decrease the third spacing of fluid, but they could also increase nocturia. Medications
ADH replacements such as Desmopressin and Vasopressin
Selective Alpha-1 blockers are the most commonly used medicine to treat BPH. Alpha-1 blockers are first line treatment for the symptoms of BPH in men. Doxazosin, terazosin, alfuzosin and tamsulosin have all been well established in treatment to reduce lower urine tract symptoms (LUTS) caused by benign prostatic hyperplasia. They are all believed to be similarly effective for this purpose. First generation alpha-1 blockers, like prazosin are not recommended to treat lower urinary tract symptoms because of their blood-pressure-lowering effect. Later generation drugs in this class are used for this purpose. In some cases alpha-1 blockers have been used in combined therapy with 5-alpha reductase blockers. Dutasteride and tamsulosin are on the market as combined therapy and results have shown that they improve symptoms significantly versus monotherapy. If urinary tract infection is causative, it can be treated with urinary antimicrobials. Antimuscarinic agents such as oxybutynin, tolterodine, solifenacin are especially used in patients who suffer from nocturia due to an overactive bladder and urgency incontinence because they help bladder contractility.