TY - JOUR
T1 - Nocturia and Nocturnal Polyuria in Neurological Patients
T2 - From Epidemiology to Treatment. A Systematic Review of the Literature
AU - Haddad, Rebecca
AU - Denys, Pierre
AU - Arlandis, Salvador
AU - Giannantoni, Antonella
AU - Del Popolo, Giulio
AU - Panicker, Jalesh N.
AU - De Ridder, Dirk
AU - Pauwaert, Kim
AU - Van Kerrebroeck, Philipp E.
AU - Everaert, Karel
N1 - Funding Information:
Financial disclosures: Rebecca Haddad certifies that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg, employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: Dr. Arlandis reports personal fees from Astellas, Medtronic, Wellspect, Coloplast, Boston Scientific, Rovi, Lacer, and Apogepha; nonfinancial support from Astellas, Coloplast, and Boston Scientific; other from Presurgy, outside the submitted work. Dr. De Ridder reports unlimited grants from Astellas, Ipsen, and Janssen Pharma; other from Ferring, Medtronic, and Bluewind, outside the submitted work. Dr. Denys reports equity interest from Menox; personal fees from Medtronic, Wellspect, Coloplast, Ipsen, Astellas, and Allergan; being part of the advisory board of Medtronic, Ipsen, and Allergan; nonfinancial support from Coloplast, Ipsen, and Allergan, outside the submitted work. Dr. Del Popolo reports personal fees from Pierre Fabre and Wellspect, outside the submitted work. Dr. Everaert reports grants from Ferring, Astellas, and Medtronic, outside the submitted work. Dr. Giannantoni reports personal fees from Allergan and Merz; nonfinancial support from Astellas, outside the submitted work. Dr. Haddad reports grants from Fonds de dotation Renaitre, Société Interdisciplinaire Francophone d'UroDynamique et de Pelvi Périnéologie, and Société Française de Médecine Physique et de Réadaptation during the conduct of the study; personal fees from Astellas, MedDay Pharmaceuticals, and Novartis Pharma SAS; nonfinancial support from Dentsply Sirona France, Astellas, Pierre Fabre Medicament, Allergan France, Bayer HealthCare SAS, and Vifor France SA, outside the submitted work. Dr. Panicker is supported in part by funding from the UK’s Department of Health NIHR Biomedical Research Centres funding scheme; reports personal fees from Astellas, Cambridge University Press, and Wellspect, outside the submitted work. Dr. Pauwaert reports grants from Ferring during the conduct of the study. Dr. Van Kerrebroeck reports personal fees from Astellas, Axonics, Ferring, Medtronic, BlueWind, and Neuspera, outside the submitted work.
Publisher Copyright:
© 2020 European Association of Urology
PY - 2020/9/15
Y1 - 2020/9/15
N2 - Context: Nocturia is among the most common and bothersome lower urinary tract symptoms (LUTS), but there is no clear consensus on how to identify and manage this symptom in the neurological population.Objective: To systematically review the literature about nocturia in neurological patients.Evidence acquisition: Studies were identified by electronic search of Cochrane and Medline databases. The studies were included if their participants had acquired neurological pathology among multiple sclerosis (MS), Parkinson's disease (PD), stroke, spinal cord injury (SCI), and reported data on the epidemiology, aetiology, diagnosis, or treatment of nocturia. An independent extraction of the articles was performed by two authors using predetermined datasets, including quality-of-study indicators.Evidence synthesis: A total of 132 studies were included; 46 evaluated the epidemiology of nocturia, 28 the possible aetiologies, 10 the diagnostic tools, and 60 the treatments. Nocturia prevalence ranged from 15% to 96% depending on the pathology and definition used. It was one of the most frequently reported LUTS in PD and stroke patients. Several validated questionnaires were found to screen for nocturia in this population. Causalities were numerous: LUT, renal, sleep, cardiovascular dysfunctions, etc. Treatments targeted these mechanisms, with an overall risk of bias assessed as high or serious. The highest level of evidence was seen in MS patients: pelvic floor muscle training, cannabinoids, and desmopressin were effective, but not melatonin. In stroke patients, transcutaneous sacral and transcutaneous tibial nerve stimulation (TTNS) improved nocturia; in PD patients, TTNS, solifenacin, and rotigotine did not.Conclusions: Nocturia is highly prevalent in patients with neurological disorders. Causalities and treatments are not different from the general population, but are poorly studied in neurological patients.Patient Summary: In this report, we looked at the published studies about nocturia the fact of waking to void during the hours of sleep in patients with neurological diseases. We found that nocturia is very frequent in this population, that the causes are the same as in the general population but may be combined, and that treatments are also the same but have an overall weak level of evidence. We conclude that more research is needed on this topic. (C) 2020 European Association of Urology. Published by Elsevier B.V. All rights reserved.
AB - Context: Nocturia is among the most common and bothersome lower urinary tract symptoms (LUTS), but there is no clear consensus on how to identify and manage this symptom in the neurological population.Objective: To systematically review the literature about nocturia in neurological patients.Evidence acquisition: Studies were identified by electronic search of Cochrane and Medline databases. The studies were included if their participants had acquired neurological pathology among multiple sclerosis (MS), Parkinson's disease (PD), stroke, spinal cord injury (SCI), and reported data on the epidemiology, aetiology, diagnosis, or treatment of nocturia. An independent extraction of the articles was performed by two authors using predetermined datasets, including quality-of-study indicators.Evidence synthesis: A total of 132 studies were included; 46 evaluated the epidemiology of nocturia, 28 the possible aetiologies, 10 the diagnostic tools, and 60 the treatments. Nocturia prevalence ranged from 15% to 96% depending on the pathology and definition used. It was one of the most frequently reported LUTS in PD and stroke patients. Several validated questionnaires were found to screen for nocturia in this population. Causalities were numerous: LUT, renal, sleep, cardiovascular dysfunctions, etc. Treatments targeted these mechanisms, with an overall risk of bias assessed as high or serious. The highest level of evidence was seen in MS patients: pelvic floor muscle training, cannabinoids, and desmopressin were effective, but not melatonin. In stroke patients, transcutaneous sacral and transcutaneous tibial nerve stimulation (TTNS) improved nocturia; in PD patients, TTNS, solifenacin, and rotigotine did not.Conclusions: Nocturia is highly prevalent in patients with neurological disorders. Causalities and treatments are not different from the general population, but are poorly studied in neurological patients.Patient Summary: In this report, we looked at the published studies about nocturia the fact of waking to void during the hours of sleep in patients with neurological diseases. We found that nocturia is very frequent in this population, that the causes are the same as in the general population but may be combined, and that treatments are also the same but have an overall weak level of evidence. We conclude that more research is needed on this topic. (C) 2020 European Association of Urology. Published by Elsevier B.V. All rights reserved.
KW - Lower urinary tract symptoms
KW - Neurogenic
KW - Nocturia
KW - Nocturnal polyuria
KW - Systematic review
KW - URINARY-TRACT SYMPTOMS
KW - TIBIAL NERVE-STIMULATION
KW - PARKINSONS-DISEASE PATIENTS
KW - NEUROGENIC DETRUSOR OVERACTIVITY
KW - MULTIPLE-SCLEROSIS PATIENTS
KW - DIURNAL BLOOD-PRESSURE
KW - CORD INJURED PATIENTS
KW - NONMOTOR SYMPTOMS
KW - BLADDER DYSFUNCTION
KW - OPEN-LABEL
U2 - 10.1016/j.euf.2020.02.007
DO - 10.1016/j.euf.2020.02.007
M3 - (Systematic) Review article
C2 - 32192920
SN - 2405-4569
VL - 6
SP - 922
EP - 934
JO - European Urology Focus
JF - European Urology Focus
IS - 5
ER -