Steven A Kaplan, MD, is the Given Foundation Professor of urology, and vice-chairman, College of Physicians and Surgeons, Columbia University, New York.
Recent studies suggest that nocturia has many etiologies, including urologic, metabolic, and perhaps most important, behavorial.
Nocturia is arguably the most distressing voiding symptom in both men and women.
Two studies reported in this issue of Urology Times help to shape our understanding of nocturia.
A second study by Van Doorn et al suggests that development of nocturia may not be related to previously associated risk factors except age (see article, page 10). However, this was in a group of men with no nocturia at baseline and with follow-up of 2.1 years. Stated otherwise, if metabolic dysfunction in this cohort of men did not result in nocturia at baseline, 2.1 years of follow-up will not shed enough light to elucidate the natural history of this symptom.
These two studies suggest that nocturia has many etiologies including urologic, metabolic, and perhaps most important, behavioral. In fact, men are often categorized as having BPH because of nocturia when in fact they may have other underlying disorders such as sleep apnea. Ultimately, therapies designed to treat nocturia need to be tailored to the underlying pathophysiology of the individual patient. The bottom line is that nocturia is an important target for patients, who will note-and greatly appreciate-even the most modest improvement.
Dr. Kaplan, a member of the Urology Times Editorial Council, is professor of urology at Weill Cornell Medical College, New York.