Presentation Authors: Elisabeth M. Sebesta*, Joseph M. Caputo, Dina Manasherova, Carrie M. Aisen, Doreen E. Chung, New York, NY
Introduction: Nocturia, waking â‰¥1 time to void during sleep with each void preceded by sleep, negatively impacts quality of life. Nocturia patients are a heterogeneous cohort due to its multifactorial causes, both urologic and systemic. Urodynamic (UDS) findings in patients with nocturia are not well described and may help guide management options. Our objective was to compare UDS findings in patients with and without nocturia.
Methods: We retrospectively reviewed UDS of 1124 patients (2010-2017), of whom 484 (43%) presented with nocturia. Age-matching of patients with and without nocturia was done, separated by gender (156 men, 596 women). Presenting symptoms, demographics, and UDS findings were compared between patients with and without nocturia.
Results: In both genders, past medical history including diabetes and cardiovascular disease did not differ between groups. However female patients with nocturia had significantly lower body mass index (BMI) (P=0.003) (TABLE). Men and women with nocturia were more likely to have daytime symptoms including frequency, urgency, and urgency incontinence (UUI). UDS findings in men did not differ between the cohorts, including findings of bladder outlet obstruction (BOO) and detrusor overactivity (DO). However, women with nocturia were more likely to have BOO (P=0.025). Men were further stratified by degree of nocturia in 27/76 (36%) patients. 37% reported 1-2 episodes per night and 63% 3 or more. When comparing to an age-matched cohort without nocturia, patients with 1-2 episodes had larger bladder capacity (602Â±386mL vs. 356Â±213mL, P=0.10), and significantly higher post-void residual (PVR) (322Â±275mL vs. 102Â±185mL, P=0.05) and incomplete emptying (P=0.005).
Conclusions: Here we present a unique study which compares UDS findings in contemporary, age- and gender-matched cohorts of patients with and without nocturia. While treatment of nocturia often attempts at resolving DO or BOO, our study suggests these findings are not necessarily present more often with nocturia. Women with nocturia were more likely to have BOO while men with mild nocturia were more likely to have larger bladder capacity, higher PVR, and incomplete emptying, suggesting an association between nocturia and longstanding BOO. This study highlights the multifactorial etiology of nocturia and its related management challenge.