Future Directions in the Treatment of Nocturia
How to cite: Rosenberg, Matt T. “Future Directions in the Treatment of Nocturia” August 11, 2018. Accessed [date today]. https://dev.grandroundsinurology.com/Future-Directions-in-the-Treatment-of-Nocturia
You can also view Dr. Rosenberg’s full presentation, “Nocturia: Symptom or Disease?“
Future Directions in the Treatment of Nocturia – Summary
Matt T. Rosenberg, MD, reviews treatment options for nocturia, such as patient counseling, medications, and newly available molecules that can safely control urine excretion from the kidneys. He also discusses quality of life burden nocturia poses on patients, as well as differentiating between nocturia and nocturnal polyuria.
Nocturia Versus Nocturnal Polyuria
Urologists define clinically relevant nocturia as waking two or more times a night to void. An enlarged prostate obstructing urine flow, overactive bladder, as well as sleep disorders are factors that could cause nocturia. Nocturnal polyuria is the overproduction of urine during the night.
The Effect of Nocturia on Everyday Life
Loss of sleep due to nocturia inhibits a patient’s work productivity, social life, and overall health. A patient waking in the first four hours of sleep especially exacerbates these symptoms.
Nocturia Management Options
The main goal of physicians treating nocturia is to decrease the urine volume going into the bladder during the night. Physicians should initially consider counseling patients on behavioral modifications and considering the diuretic effects of the patient’s current medications when treating nocturia.
Management of Kidney Urine Production
In some cases, nocturia can be a result of kidney dysfunction. Previous treatments for nocturia had the side effect of hyponatremia, which can increase intravascular volume. Therefore, this could put patients with congestive failure at risk.
Fortunately, the newly available versions of desmopressin are short acting, with a four to six hour half-life, and require a low dose, decreasing the risk of severe hyponatremia. These molecules affect the distal and collecting ducts in order to slow the excretion of urine in the bladder.
About Dr. Rosenberg
Dr. Rosenberg is a family medicine physician in Jackson, Michigan. Due to his background in family medicine, he has much experience in treating patients with nocturia.
About the Future Directions in Urology Symposium
The Future Directions in Urology Symposium (FDUS) is an annual collaborative meeting with a faculty consisting of the top researchers, physicians, and educators in the field of urology. During FDUS, experts provide updates on recent developments and debate innovative management approaches in genitourinary cancers and urologic conditions. Subsequently, the experts devise consensus statements in accordance with the discussions held in the meeting.
In this video, Dr. Rosenberg discloses the thesis of the discussion he led during FDUS.
ABOUT THE AUTHOR
Matt T. Rosenberg, MD, earned his medical degree at the University of California, Irvine, where he trained in general surgery. He also trained in urologic surgery at Brigham and Women’s Hospital in Boston before changing fields to general practice. Dr Rosenberg has a special interest in the medical management of urologic diseases and has authored or coauthored articles appearing in Urology, The Journal of Urology, BJU International, The International Journal of Clinical Practice, and other peer-reviewed journals. He now practices in Jackson, Michigan, serving as Medical Director of Mid-Michigan Health Centers, and on staff at Allegiance Health, where he served as Chief of the Department of Family Medicine from 2003 to 2006. Dr. Rosenberg is a Senior Editor at the International Journal of Clinical Practice and is Founder and Chairman of the Urologic Health Foundation, a nonprofit group dedicated to the education of primary care physicians in the field of genitourinary disease. In 2011, he was appointed by the AUA Office of Education to be the Coordinator of Primary Care Education.
