The Importance of Terminology for Quantifying Nocturia in Practice

Abstract

BackgroundAlthough nocturia, affecting mainly the elderly population, is a urinary tract symptom, it may also be a part of conditions not related to the urinary tract. In this scenario, nocturia terminology is crucial to avoid confusion and misunderstanding across different specialities. The International Continence Society (ICS) provides the updated nocturia terminology. ObjectiveTo review, describe, and explain the applicability of nocturia terminology based on the ICS standardisation documents. Design, setting, and participantsThe ICS report provides definitions on the terminology for nocturia and nocturnal lower urinary tract function, which were identified and summarised. Outcome measurements and statistical analysisTerminology was classified as symptoms and signs, and an explanation of how terms are applied in a bladder diary for use in clinical practice was given. Results and limitationsTerminology was classified into symptoms and signs. Nocturia is a symptom where the patient reports waking up to pass urine during their main sleep period, and every episode is followed by sleep or the intention to sleep. Nocturnal polyuria is a symptom when the patient perceives that they have passed large volumes of urine during the main sleep period. Enuresis is the complaint of incontinence that occurs while a patient is asleep and is usually unaware of it. All these terms can be a sign when quantified on the bladder diary. The remaining terminology is identified and quantified on the 3-d bladder diary (24-h voided volume, 24-h polyuria, nocturnal urine volume, night-time frequency, first morning void, night-time main sleep period). ConclusionsThe health care provider must understand the critical differences between the different terms. It will facilitate communication among all the professionals involved in the care of these patients. A 3-d bladder diary is a fundamental tool for assessing nocturia. Patient summaryThis paper has the objective of defining and explaining all the terms currently used for nocturia. For this purpose, we utilised the published standard terminology and summarised it with examples for better understanding and applicability.