The Impact of Nocturia in Patients with LUTS/BPH: Need for New Recommendations

Although nocturia has been recognised as one of the most bothersome symptoms in men suffering from lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH), its impact on quality of life (QoL) is often underestimated. Recent studies have shown a substantial negative effect of nocturia on quality of sleep, energy/vitality and social functioning. In addition, it has been shown that quality of sleep is significantly affected by the hours of undisturbed sleep (HUS), defined as the time between going asleep and the first awakening (to void). These considerations formed the basis to investigate current opinion on the appropriate evaluation of nocturia amongst both practising urologists and urological experts. For that purpose, firstly a discussion forum was organised at the 6th International Consultation on Prostate Cancer and Prostate Diseases (Paris, June 24, 2005), followed by a meeting of an expert consensus panel (Sheffield, September 24, 2005). Based on the results of both meetings, seven position statements were formulated regarding the measurement of nocturia and its impact on QoL in future research.Participants of both the discussion forum and the expert consensus meeting confirmed the importance of the appropriate evaluation of nocturia in patients with LUTS/BPH, focusing on an accurate analysis of its causes, and also on its impact on quality of sleep and QoL. The concept of HUS was broadly acknowledged as a potentially important parameter in assessing sleep disturbance due to nocturnal voids. The expert panel recommended that the relation between nocturia, quality of sleep and QoL should be incorporated into new studies on the efficacy of treatments for LUTS/BPH. Sleep logs/diaries, the measurement of HUS (by either sleep logs or recently developed instruments such as the actigraph) and the Nocturia Specific Quality of Life questionnaire (N-QOL) were suggested as important tools to measure nocturia and its impact in future clinical and epidemiological studies.