How can we develop a more clinically useful and robust algorithm for diagnosing and treating nocturia? ICI‐RS 2017

Everaert, Karel; Hervé, François; Bower, Wendy; Djurhuus, Jens Christian; Dmochowski, Roger R.; Fine, Noam D.; Wein, Alan J.; Wyndaele, Michel; Weiss, Jeffrey P.

doi:10.1002/nau.23569

Cited by 24 publications

(30 citation statements)

References 53 publications

(70 reference statements)

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“…Other factors that will influence the impact of concomitant medication are the timing of administration, mode of administration, formulation (long‐ vs short‐acting), and so on. Most of these factors have not been well studied …”

Section: Resultsmentioning

confidence: 99%

“…During the 2017 meeting of the International Consultation on Incontinence‐Research Society (ICI‐RS) in Bristol, a nocturia think‐tank discussed how to study the gaps in our knowledge to develop a practical patient‐oriented diagnostic and therapeutic algorithm for nocturia . It was obvious that the many and varied causes of the condition are underdiagnosed and that many clinicians of different disciplines see patients with nocturia without paying specific attention to diagnosing and treating their excessive nocturnal voiding.…”

Section: Introductionmentioning

confidence: 99%

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International Continence Society consensus on the diagnosis and treatment of nocturia

Everaert

Hervé

Bosch

et al. 2019

Neurourology and Urodynamics

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Introduction Patients with nocturia have to face many hurdles before being diagnosed and treated properly. The aim of this paper is to: summarize the nocturia patient pathway, explore how nocturia is diagnosed and treated in the real world and use the Delphi method to develop a practical algorithm with a focus on what steps need to be taken before prescribing desmopressin. Methods Evidence comes from existing guidelines (Google, PubMed), International Consultation on Incontinence‐Research Society (ICI‐RS) 2017, prescribing information and a Delphi panel (3 rounds). The International Continence Society initiated this study, the authors represent the ICI‐RS, European Association of Urology, and Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU). Results Diagnostic packages: consensus on, history taking for all causalities, intake diary (fluid, food) and bladder diary, not for its duration. Pelvic (women) or rectal (men) examination, prostate‐specific antigen, serum sodium check (SSC), renal function, endocrine screening: when judged necessary. Timing or empty stomach when SSC is not important. Therapeutic packages: the safe candidates for desmopressin can be phenotyped as no polydipsia, heart/kidney failure, severe leg edema or obstructive sleep apnea syndrome. Lifestyle interventions may be useful. Initiating desmopressin: risk management consensus on three clinical pictures. Follow‐up of desmopressin therapy: there was consensus on SSC day 3 to 7, and at 1 month. Stop therapy if SSC is <130 mmol/L regardless of symptoms. Stop if SSC is 130 to 135 mmol/L with symptoms of hyponatremia. Conclusion A summary of the nocturia patient pathway across different medical specialists is useful in the visualization and phenotyping of patients for diagnosis and therapy. By summarizing basic knowledge of desmopressin, we aim to ease its initiation and shorten the patient journey for nocturia.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

International Continence Society consensus on the diagnosis and treatment of nocturia

Everaert

Hervé

Bosch

et al. 2019

Neurourology and Urodynamics

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“…This knowledge–practice gap suggests that nocturia may be the single biggest potentially modifiable risk factor in older people at risk of falling during the night. Future work should translate nocturia management algorithms to the hospital ward context …”

Section: Discussionmentioning

confidence: 99%

Toileting‐related falls at night in hospitalised patients: The role of nocturia

et al. 2019

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Objective The purpose of this study was to describe the prevalence and characteristics of toileting‐related falls in hospitalised older people. Methods Retrospective analysis of falls related to night‐time toileting in patients 60 years or over in a tertiary hospital during a one‐year period. Results Overall 34% of falls were related to toileting with at least 44% of these falls occurring during the night. Toilet‐related falls peaked between 11 pm and 1 am, a period that coincides with maximum supine‐induced diuresis. Almost half of night falls occurred at the bedside. In 80% of night toileting‐related falls, patients were mobilising without the recommended level of assistance. Half of all patients had no strategies for toileting documented in their care plan. Conclusion Findings support screening for nocturia in older inpatients and implementation of strategies to reduce both the need for toileting at night and risk factors for falling.

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“…The previous Incontinence‐Research Society (ICI‐RS) Nocturia Think Tank summarized the gaps in our knowledge in diagnosis and therapy of nocturia needed to develop algorithms.…”

Section: Introductionmentioning

confidence: 99%

Is our current understanding and management of nocturia allowing improved care? International Consultation on Incontinence‐Research Society 2018

Hervé

Abrams

Bower

et al. 2019

Neurourology and Urodynamics

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Aims: Nocturia or waking at night, to urinate is a common cause of awakenings and may lead to sleep disturbance, impaired somatic health, impaired quality of life, and increased mortality.The aim of this report is to point out and discuss the aspects and issues that need to be addressed to improve the care of nocturia. Methods: This paper is a report of the presentations and subsequent discussion of a Think Tank session at the annual International Consultation on Incontinence-Research Society (ICI-RS) in June 2018 in Bristol.Results and conclusion: Nocturia is a known risk factor for in-hospital falls. Unfortunately, its assessment in acutely hospitalized (older) people is not the current practice and ward-based care plans are not tailored to this symptom. A new care pathway for hospitalized patients who have nocturia should be considered.

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How can we develop a more clinically useful and robust algorithm for diagnosing and treating nocturia? ICI‐RS 2017

Cited by 24 publications

References 53 publications

International Continence Society consensus on the diagnosis and treatment of nocturia

International Continence Society consensus on the diagnosis and treatment of nocturia

Toileting‐related falls at night in hospitalised patients: The role of nocturia

Is our current understanding and management of nocturia allowing improved care? International Consultation on Incontinence‐Research Society 2018

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