Impact of surgical treatment on nocturia in men with benign prostatic obstruction

Abstract

Several important topics are presented in this section, including the impact of surgical treatment on nocturia in men with BPH, pelvic floor exercises for stress urinary incontinence, chronic prostatitis in puberty, introital ultrasonography, and a systematic review published work on a stent for managing BPH. OBJECTIVES To validate the International Consultation on Incontinence Nocturia Quality‐of‐life (NQoL) questionnaire in Italian (IT‐NQoL) and use it to evaluate the impact of surgical treatment on nocturia in men with lower urinary tract symptoms related to benign prostatic obstruction (LUTS/BPO). PATIENTS AND METHODS All men attending one urological unit between November 2004 and April 2005 were enrolled in the study. They were assessed in two groups; those with and with no LUTS/BPO. An Italian translation of the NQoL was devised, and patients then completed this and validated Italian versions of the International Prostate System Score (IPSS), the Pittsburg Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Clinical, laboratory and instrumental data from each patient were recorded. The patients with LUTS/BPO then had surgical treatment, and 6 months later those with LUTS/BPO were asked to complete all the questionnaires again to evaluate the test sensitivity to change. RESULTS Of the 109 patients enrolled in the study, 61 were affected by LUTS/BPO and 48 were not. Cronbach’s α for the IT‐NQoL was 0.943 (95% confidence interval, CI, 0.922–0.959; P < 0.001) and the intra‐class correlation coefficient was 0.999 (95% CI 0.998–0.999; P < 0.001) for the total IT‐NQoL score. The correlation between the test and the re‐test was statistically significant (P < 0.001; r = 0.999) for all items. The mean (sd) IT‐NQoL score showed an improvement in QoL from before, at 23.4 (10.1), to after treatment, at 3.09 (2.48) (P < 0.001). In the LUTS/BPO group, the IT‐NQoL correlated with the number of times when waking to urinate (Pearson’s coefficient 0.80, P < 0.001). There was also a correlation for ESS (0.796) and for the seven PSQI subscales (0.614, both P < 0.001). The decrease in sleep quality, duration and efficiency resulted in an increase in daytime sleepiness (r = 0.639, 0.642). At the 6‐month follow‐up, all questionnaire results were statistically different from those before treatment. CONCLUSIONS The IT‐NQoL is the first validated translation of the primary instrument into another language. This version is easy to use and has the same characteristic validity as the English version. Using the IT‐NQoL showed that surgical treatment determines a decrease in the nocturia rate and an increase in QoL. There was also a significant increase in QoL after treatment as assessed by all the other questionnaires.

The impact of sleep apnoea syndrome on nocturia according to age in men

“…In one study conducted in 547 men, nocturia was found to be signifi cantly associated with depressive symptoms, and it was suggested that nocturia may be predictive of depression [ 27 ] . Another study reported a signifi cant correlation between the severity of nocturia and poor sleep quality, and found that sleep quality was improved after surgical intervention [ 28 ] . Although a close association exists between depressive symptoms, poor sleep quality and nocturia, no causal relationship has been established.…”

Nocturia Compounds Nocturnal Wakefulness in Older Individuals with Insomnia

“…[2][3][4][5][6] Further, survey studies have shown that the greater the number of nocturnal voids, the greater the self-described poor sleep, insomnia symptoms, and daytime sleepiness. [7][8][9][10][11][12][13][14][15] For those individuals who report nocturia as bothersome there is even a stronger correlation with disturbed sleep. 13,16 As noted, to date, no study of the relationship between sleep and nocturia has used objective measurements of sleep, nor have previous studies examined the relationship between sleep and nocturia prospectively, on a night-to-night basis.…”

Evaluation and Management of Nocturia in Older Men

“…The proper assessment of nocturia in patients with LUTS was traditionally difficult to define because most questionnaires included nocturia among other LUTS and added them together to form a score (eg, International Prostate Symptom Score [IPSS]/American Urologic Association Symptom Score, Benign Prostatic Hyperplasia Impact Index, Danish Prostatic Symptom Score) [36]. Very few instruments examine the impact of nocturia alone on QoL.…”

“…The 12 items pertaining to nocturia are scored from 0 (no symptoms) to 4 (symptoms always present). The 13th item related to QoL is scored from 0 (no symptoms) to 10 (severe nocturia impact on QoL) [36,41]. The questionnaire takes approximately 5 min to fill out, and scores range from 0 to 48 [41].…”