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Assessment of nocturia 

Assessment of nocturia
Assessment of nocturia

Marcus Drake

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date: 23 October 2019

Patients suffering from nocturia need a thorough medical and surgical history and a focused clinical examination. Baseline investigations required for patients suffering with nocturia include: height and weight to calculate the body mass index; bladder diary, e.g. the ICIQ-Bladder Diary; quality of life questionnaire, e.g. ICIQ-N and ICIQ-NQoL; urinalysis, e.g. ‘dipstick’; flow rate and post-void residual measurement; and biochemical tests, e.g. renal electrolytes. Further urological investigations, such as urodynamics, cystoscopy, or imaging, are not indicated, unless an abnormality is suspected on baseline investigations and after failure of conservative and medical therapy. Patients are usually referred to the urologist for nocturia. However, following a thorough investigation, patients may need to be referred to another specialty. For example, if there is 24-hour polyuria, then the patient should be referred to an endocrinologist; if they have sleep disorders, such sleep apnoea (snoring, respiratory arrests), nocturnal seizures, parasomnias (nocturnal motor and behavioural phenomena), or excessive daytime sleepiness (sleep episodes, imperative sleepiness), then they should be referred for sleep evaluation studies. Similarly, if there are psychological problems, then the patient will need to be referred to a psychologist or psychiatrist.

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