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Nocturia

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Updated 2024 EAU guidelines for the evaluation and management of nocturia.

Guidelines

Key sources

The following summarized guidelines for the evaluation and management of nocturia are prepared by our editorial team based on guidelines from the European Association of Urology (EAU 2024), the European Association of Urology (EAU/EAUN 2024), the Canadian Urological Association (CUA 2022), and the European Academy of Neurology (EAN 2020). ...
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Diagnostic investigations

History and physical examination: as per EAU 2024 guidelines, elicit a complete medical history in male patients with LUTS.
A
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  • Laboratory tests

  • Post-void residual volume

  • Urodynamic studies

  • Screening for obstructive sleep apnea

Diagnostic procedures

Cystoscopy: as per CUA 2022 guidelines, do not perform cystoscopy in patients with nocturia.
D

Medical management

General principles: as per EAU 2024 guidelines, treat underlying causes of nocturia, including behavioral, systemic conditions, sleep disorders, lower urinary tract dysfunction, or a combination of factors.
B

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  • Desmopressin

  • Anti-LUTS therapy

  • Diuretics

  • Imipramine

  • Vaginal estrogen

Nonpharmacologic interventions

Lifestyle modifications: as per EAU 2024 guidelines, discuss behavioral changes with the patient to reduce nocturnal urine volume and episodes of nocturia and improve sleep quality.
B

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  • Pelvic floor muscle training

Specific circumstances

Patients with multiple sclerosis: as per EAN 2020 guidelines, consider offering desmopressin intranasal spray for nocturia in patients with severe multiple sclerosis. Do not offer desmopressin intranasal spray in patients with uncontrolled hypertension, cardiovascular, and/or renal diseases.
C