Context

The treatment of nocturia is a key challenge due to the multi-factorial pathophysiology of the symptom and the disparate outcome measures used in research.

Objective

To assess and compare available therapy options for nocturia, in terms of symptom severity and quality of life.

Evidence acquisition

Medical databases (Embase, Medline, Cochrane Systematic Reviews, Cochrane Central) were searched with no date restriction. Comparative studies were included which studied adult men with nocturia as the primary presentation and lower urinary tract symptoms including nocturia or nocturnal polyuria. Outcomes were symptom severity, quality of life, and harms.

Evidence synthesis

We identified 44 articles. Antidiuretic therapy using dose titration was more effective than placebo in relation to nocturnal voiding frequency and duration of undisturbed sleep; baseline serum sodium is a key selection criterion. Screening for hyponatremia (< 130 mmol/l) must be undertaken at baseline, after initiation or dose titration, and during treatment. Medications to treat lower urinary tract dysfunction (α-1 adrenergic antagonists, 5-α reductase inhibitors, phosphodiesterase type 5inhibitor, antimuscarinics, beta-3 agonist, and phytotherapy) were generally not significantly better than placebo in short-term use. Benefits with combination therapies were not consistently observed. Other medications (diuretics, agents to promote sleep, nonsteroidal anti-inflammatories) were sometimes associated with response or quality of life improvement. The recommendations of the Guideline Panel are presented.

Conclusions

Issues of trial design make therapy of nocturia a challenging topic. The range of contributory factors relevant in nocturia makes it desirable to identify predictors of response to guide therapy. Consistent responses were reported for titrated antidiuretic therapy. For other therapies, responses were less certain, and potentially of limited clinical benefit.

Patient summary

This review provides an overview of the current drug treatments of nocturia, which is the need to wake at night to pass urine. The symptom can be caused by several different medical conditions, and measuring its severity and impact varies in separate research studies. No single treatment deals with the symptom in all contexts, and careful assessment is essential to make suitable treatment selection.

中文翻译：

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男性下泌尿道症状男性夜尿的药物治疗：欧洲泌尿外科协会指导方针小组针对男性下泌尿道症状的系统评价

语境

由于症状的多因素病理生理以及研究中使用的不同结果指标，夜尿的治疗是一项关键挑战。

客观的

在症状严重程度和生活质量方面评估和比较夜尿可用的治疗选择。

取证

搜索医学数据库（Embase，Medline，Cochrane系统评价，Cochrane Central），没有日期限制。比较研究包括以夜尿为主的成年男性和包括夜尿或夜间多尿的下尿路症状的成年男性。结果是症状严重程度，生活质量和伤害。

证据综合

我们确定了44篇文章。在夜间排尿频率和无干扰睡眠时间方面，采用剂量滴定的抗利尿疗法比安慰剂更有效。基线血清钠是关键的选择标准。必须在基线，开始或剂量滴定后以及治疗期间筛查低钠血症（<130 mmol / l）。在短期使用中，用于治疗下尿路功能障碍的药物（α-1肾上腺素能拮抗剂，5-α还原酶抑制剂，磷酸二酯酶5型抑制剂，抗毒蕈碱剂，β-3激动剂和植物疗法）通常不会明显好于安慰剂。不能始终观察到联合疗法的益处。其他药物（利尿剂，促进睡眠的药物，非甾体类抗炎药）有时与缓解或改善生活质量有关。

结论

审判设计的问题使夜尿疗法成为一个具有挑战性的话题。与夜尿症相关的影响因素的范围使人们希望确定对指导治疗反应的预测因素。据报道滴定抗利尿剂治疗的反应一致。对于其他疗法，反应较不确定，可能对临床的益处有限。

病人总结

这篇综述概述了夜尿症的当前药物治疗方法，这是需要在夜间醒来以通过尿液的方法。症状可能是由几种不同的医学状况引起的，其严重性和影响的程度在单独的研究中有所不同。在所有情况下，没有一种单一的治疗方法可以治疗症状，因此仔细评估对于选择合适的治疗方法至关重要。