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Pesonen JS, Cartwright R, Mangera A, Santti H, Griebling TL, Pryalukhin AE, Riikonen J, Tähtinen RM, Agarwal A, Tsui JF, Vaughan CP, Markland AD, Johnson TM, Fonsell-Annala R, Khoo C, Tammela TLJ, Aoki Y, Auvinen A, Heels-Ansdell D, Guyatt GH, Tikkinen KAO. Incidence and Remission of Nocturia: A Systematic Review and Meta-analysis. Eur Urol 2016; 70:372-81. [PMID: 26905787 DOI: 10.1016/j.eururo.2016.02.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 02/02/2016] [Indexed: 10/22/2022]
Abstract
CONTEXT Although vital for decision-making about management, the natural history of nocturia remains uncertain. A systematic review would clarify the issue, but because natural history reviews are uncommon it would require methodological innovations. OBJECTIVE To estimate the incidence and remission of nocturia, and refine methods for meta-analyses assessing natural history. EVIDENCE ACQUISITION We conducted a comprehensive search of PubMed, Scopus, and Cumulative Index of Nursing and Allied Health Literature databases and abstracts of major urologic meetings as far as August 31, 2015. Random effects meta-analyses addressed incidence/remission rates of nocturia; meta-regression explored potential determinants of heterogeneity. Studies were categorized as either low or high risk of bias using a novel instrument specifically designed for longitudinal symptom studies aimed at the general population. EVIDENCE SYNTHESIS Of 4165 potentially relevant reports, 16 proved eligible. Pooled estimates from 13 studies (114 964 person-years of follow-up) demonstrated that annual incidence was strongly associated with age: 0.4% (0-0.8%) for adults aged < 40 yr; 2.8% (1.9-3.7%) for adults aged 40-59 yr; and 11.5% (9.1-14.0%) for adults aged ≥ 60 yr. Of those with nocturia, each year 12.1% (9.5-14.7%) experienced remission. CONCLUSIONS The available evidence suggests that nocturia onset is strongly associated with age, with much higher rates in those over 60 yr; remission occurs in approximately 12% each year. These estimates can aid with management decisions and counseling related to nocturia. PATIENT SUMMARY We reviewed all previous studies of progression of night-time urination (nocturia). We found that in any given year 0.4% of adults aged < 40 yr, 3% of adults aged 40-59 yr, and 12% of adults aged ≥ 60 yr will develop nocturia, while overall 12% of those with nocturia will improve. These findings may be helpful in making decisions about coping with or treating nocturia.
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Affiliation(s)
- Jori S Pesonen
- Department of Urology, Päijät-Häme Central Hospital, Lahti, Finland; Department of Urology, Tampere University Hospital and Medical School, University of Tampere, Tampere, Finland
| | - Rufus Cartwright
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK; Department of Urogynaecology, Imperial College London, London, UK
| | - Altaf Mangera
- Department of Urology, Sheffield Teaching Hospitals, Sheffield, UK
| | - Henrikki Santti
- Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tomas L Griebling
- Department of Urology, University of Kansas and The Landon Center On Aging, Kansas City, KS, USA
| | - Alexey E Pryalukhin
- North-Western State Medical University named after I.I. Mechnikov, Department of Urology, Saint Petersburg, Russia; Department of Pathology, Saarland University Medical Center, Homburg, Germany
| | - Jarno Riikonen
- Department of Urology, Tampere University Hospital and Medical School, University of Tampere, Tampere, Finland
| | - Riikka M Tähtinen
- Department of Obstetrics and Gynecology, Kuopio University Hospital, Kuopio, Finland
| | - Arnav Agarwal
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - Johnson F Tsui
- Department of Urology, Lenox Hill Hospital, New York, NY, USA
| | - Camille P Vaughan
- Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research Education and Clinical Center, Atlanta, GA, USA
| | - Alayne D Markland
- Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research Education and Clinical Center, Atlanta, GA, USA
| | - Theodore M Johnson
- Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research Education and Clinical Center, Atlanta, GA, USA
| | | | - Charlie Khoo
- Department of Urology, Royal Free Hospital, London, UK
| | - Teuvo L J Tammela
- Department of Urology, Tampere University Hospital and Medical School, University of Tampere, Tampere, Finland
| | - Yoshitaka Aoki
- Department of Urology, University of Fukui, Faculty of Medical Sciences, Fukui, Japan
| | - Anssi Auvinen
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - Diane Heels-Ansdell
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - Gordon H Guyatt
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Kari A O Tikkinen
- Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland.
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