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Management of refractory and complex cases of nocturia 

Management of refractory and complex cases of nocturia
Management of refractory and complex cases of nocturia

David James Osborn

, Haerin Lee

, and Roger Dmochowski

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date: 25 June 2022

No evidence-based treatments are available for the treatment of refractory or complex nocturia. Assessment may involve further investigations such as computed tomography, magnetic resonance imaging, cystoscopy, or urodynamics. If nocturia is due to incomplete emptying of the bladder, then treatment options can include intermittent catheterization or long-term urethral or suprapubic catheterization. If nocturia is due to an overactive bladder, then treatment options include botulinum toxin A, sacral nerve stimulation, augmentation cystoplasty, or urinary diversion. Alternative medicine, such as reflexology, hypnotherapy, and acupuncture, can also be tried. Patients need to be made aware that, in refractory and complex cases, none of the treatments have a high level of evidence, and therefore treatment will be individualized according to bothersomeness and effect on quality of life.

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