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PURPOSE: Although maternal depression is associated with adverse outcomes in women and children, its relationship with lower urinary tract symptoms (LUTS) in offspring is less well-characterized. We examined the association between prenatal and postpartum maternal depression and LUTS in primary school-age daughters. DESIGN: Observational cohort study. SUBJECTS AND SETTING: The sample comprised 7148 mother-daughter dyads from the Avon Longitudinal Study of Parents and Children. METHOD: Mothers completed questionnaires about depressive symptoms at 18 and 32 weeks gestation and 21 months postpartum and their childrens LUTS (urinary urgency, nocturia, and daytime and nighttime wetting) at 6, 7, and 9 years of age. Multivariable logistic regression models were used to estimate the association between maternal depression and LUTS in daughters. RESULTS: Compared to daughters of mothers without depression, those born to mothers with prenatal and postpartum depression had higher odds of LUTS, including urinary urgency (adjusted odds ratio [aOR] range = 1.99-2.50) and nocturia (aOR range = 1.67-1.97) at 6, 7, and 9 years of age. Additionally, daughters born to mothers with prenatal and postpartum depression had higher odds of daytime wetting (aOR range = 1.81-1.99) and nighttime wetting (aOR range = 1.63-1.95) at 6 and 7 years of age. Less consistent associations were observed for depression limited to the prenatal or postpartum periods only. CONCLUSIONS: Exposure to maternal depression in the prenatal and postpartum periods was associated with an increased likelihood of LUTS in daughters. This association may be an important opportunity for childhood LUTS prevention. Prevention strategies should reflect an understanding of potential biological and environmental mechanisms through which maternal depression may influence childhood LUTS.

Aim Methods Results Conclusion To estimate the prevalence of nocturia in middle‐aged and elderly men and evaluate its associated factors and changes over time.Data of middle‐aged and older men aged ≥40 years from the 2007–2008 and 2017–2020 cycles of the National Health and Nutrition Examination Survey were retrospectively analyzed. The prevalence of nocturia was estimated using participant questionnaires on nocturia, lifestyle‐related factors, and health factors, and its decadal changes were examined using multivariate logistic regression analysis to determine related factors associated with the prevalence of nocturia.The prevalence of nocturia was 38.0% in 2007–2008 and 39.6% in 2017–2020, with no significant increase observed (P = 0.3989). Being a non‐Hispanic black was positively correlated with nocturia (adjusted odds ratio [AOR] = 1.54, 1.22–1.93, P < 0.001), whereas the correlation with being a Mexican American disappeared (AOR = 1.25, 0.90–1.73, P = 0.187). Diabetes (AOR = 1.32, 1.07–1.64, P = 0.010) and sleep disorders (AOR = 1.31, 1.07–1.60, P = 0.008) showed a statistically significant positive correlation with nocturia, whereas a significant negative correlation was observed between employment (AOR = 0.66, 0.54–0.82, P < 0.001) and nocturia. Above‐high‐school education (AOR = 0.60, 0.47–0.76, P < 0.001) showed a constant trend toward a negative correlation with nocturia. The correlation between high school education or general educational development and nocturia disappeared (AOR = 0.81, 0.62–1.05, P = 0.112).Diabetes and sleep disorders contribute to the development of nocturia, while work and high educational attainment can actively combat nocturia. Geriatr Gerontol Int 2024; ••: ••–••. [ABSTRACT FROM AUTHOR]

Objectives: Nocturia is considered a clinical problem when nocturnal urinary frequency is two or more times. For affected patients, development of depression, falling, and increased mortality rate are matters of concern. The present study investigated the efficacy and safety of lemborexant for insomnia patients with nocturia. Methods: Insomnia patients (Athens Insomnia Scale [AIS] ≥ 6) who typically awoke twice or more during the night to urinate and were examined at our institutions from June 2021 to December 2022 were enrolled. Each was administrated 5 mg of lemborexant, one tablet, daily for 4 weeks. Total AIS score, nocturia frequency, individual frequency‐volume chart findings, and N‐QOL score were examined before and after administration. Results: Of the 37 patients recruited, 5 were excluded, thus 32 were enrolled and subjected to analyses. Following lemborexant therapy, the mean AIS total score was significantly decreased from 11.4 to 7.8 (p < 0.01) as was mean number of nocturia episodes from 3.4 to 2.3 (p < 0.001). Furthermore, the mean single voided urine volume at night was significantly increased from 182.5 to 225.3 mL (p < 0.001)and mean period of undisturbed sleep was significantly extended from 105.3 to 174.8 min (p < 0.001), while mean total N‐QOL score was significantly improved from 49.6% to 64.8% (p < 0.001). As for adverse events, mild somnolence was observed in three cases. Conclusions: Lemborexant may be effective and safe for use in insomniac patients with nocturia. [ABSTRACT FROM AUTHOR]

Objective: To determine prevalence of UTI in pregnant women and its associated risk factors at a tertiary care hospital. Study Design: Cross Sectional study. Setting: Department of Gynae & Obstetrics Independent University Hospital, Faisalabad. Period: 1-10-2022 to 31-3-2023. Methods: All pregnant patients visiting gynae OPD (5280) were enrolled for study. Mid-stream urine sample was taken and analyzed. UTI was diagnosed if >10 pus cells / HPF were seen. Inclusion Criteria: All pregnant females attending antenatal clinic during study period. Exclusion Criteria: Women with chronic renal disease. History of antibiotic treatment in last one week, Congenital renal abnormality. Patients on immuno suppressive therapy. Results: The prevalence of UTI in our study was 28%. In this study 593 patients (40%) were <20 years of age, 258(17%) were in 21-30 years age group, 246 (16%) were 31-40 years and 381(26%) were >40 years of age. In our study 526 (35%) were primigravidas, 249(17%) were G2, 272(18%) were G3 and 431 (29%) were G4 or above. In this study 698 (47%) patients were in first trimester, 320(22%) were in second trimester, 460(31%) in third trimester. Among risk factors 245 patients (16%) were anemic and 421(28%) were diabetic. Conclusion: The Prevalence of UTI in pregnant female of independent university hospital Faisalabad is quite high. Anemia and diabetes are major associated risk factors. Owing to its association with a number of complications, UTI needs to be diagnosed and treated promptly to lessen perinatal and maternal morbidity and mortality. [ABSTRACT FROM AUTHOR]

Background: Despite its widespread adoption in cardiovascular research, the application of LE8 in other health conditions, particularly urgency urinary incontinence (UUI) and nocturia, has not been thoroughly investigated. Our study used the Life's Essential 8 (LE8) score to evaluate the relationship between cardiovascular health (CVH) and urge urinary incontinence and nocturia in adults. Methods: This analysis utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 2011–2018. We used the LE8 score as the independent variable, and UUI and nocturia as the dependent variables. Multivariable logistic regression was conducted to explore the association between the LE8 score and the occurrence of UUI and nocturia. Results: The study included 12,566 adults aged 20 and older. After adjusting for potential confounders, a higher LE8 score was inversely associated with the risk of UUI (OR = 0.38; 95% CI: 0.27–0.52, p < 0.0001) and nocturia (OR = 0.53; 95% CI: 0.44–0.65, p < 0.0001). Conclusion: This cross-sectional study revealed an inverse relationship between the LE8 score and the likelihood of both UUI and nocturia. [ABSTRACT FROM AUTHOR]

Background: There is growing evidence of a possible correlation between depression and overactive bladder (OAB). However, few studies have classified depression according to its severity. Whether there is an association between different levels of depression and OAB symptoms remains unclear. Methods: Participants with complete information about depression, OAB, and covariates in the National Health and Nutrition Examination Survey (NHANES) 2005–2018 were included in this study. Depression symptoms were assessed by the Patient Health Questionnaire‐9. OAB symptoms were evaluated by the Overactive Bladder Symptom Score. Weighted multivariate logistic regression models were applied to analyze the relationship between depression and OAB. Results: A total of 30 359 participants were included in this study, consisting of 6245 OAB patients and 24 114 non‐OAB participants. The multivariate logistic regression suggested depression independently correlated with OAB (odds ratio [OR] = 2.764, 95% confidence interval [CI] = 2.429–3.146, p < 0.001). Further, mild (OR = 2.355, 95% CI = 2.111–2.627, p < 0.001), moderate (OR = 3.262, 95% CI = 2.770–3.841, p < 0.001), and moderately severe to severe depression (OR = 3.927, 95% CI = 3.246–4.752, p < 0.001) were all associated with OAB. Additionally, depression was also correlated with urgency urinary incontinence (OR = 2.249, 95% CI = 1.986–2.548, p < 0.001) and nocturia (OR = 2.166, 95% CI = 1.919–2.446, p < 0.001). Conclusion: This study indicated different levels of depression, even mild depression, were independent risk factors for OAB. Given the frequent coexistence and potential interactions between depression and OAB, clinicians should be aware of the importance of assessing both physical and psychological symptoms in these patients. Early diagnosis and holistic treatment may improve the treatment outcomes, particularly for those suffering from both conditions. [ABSTRACT FROM AUTHOR]

Objective: This study aims to investigate how arthritis, including osteoarthritis and rheumatoid arthritis, affects the incidence of nocturia in adults aged 20–59. Methods: This study utilized data from the National Health and Nutrition Examination Survey from 2005 to 2020, involving 18 745 adults aged 20–59. Arthritis, including osteoarthritis and rheumatoid arthritis, was considered as the exposure factor, with nocturia as the outcome variable. We first compared the baseline characteristics of individuals with and without nocturia. The impact of arthritis on nocturia was assessed using weighted multivariate logistic regression models. To ensure the stability of the results, propensity score matching analysis and subgroup analyses were conducted. Results: The incidence of nocturia was approximately 22.31%, and the incidence of arthritis was about 15.32% (2871/18 745), with osteoarthritis accounting for 35.49% (1019/2871) and rheumatoid arthritis accounting for 20.20% (580/2871). Adjusted multivariate logistic regression analysis revealed that the risk of nocturia was increased by arthritis (odds ratio [OR] = 1.45, 95% confidence interval [CI]: 1.28–1.65, p < 0.0001), including osteoarthritis (OR = 1.45, 95% CI: 1.18–1.78, p < 0.001) and rheumatoid arthritis (OR = 1.51, 95% CI: 1.14–2.00, p = 0.004). After propensity score matching using nearest neighbor methods at a 1:1 ratio, this relationship still exists. Subgroup analyses showed no significant differences in the interactions between arthritis and the risk of nocturia across various factors, such as age, family income to poverty ratio, education level, body mass index, smoking status, hypertension, and diabetes. However, significant differences were observed across different sex groups and sleep trouble groups. Conclusions: This study revealed that arthritis, including osteoarthritis and rheumatoid arthritis, increased the risk of nocturia in adults under the age of 60. [ABSTRACT FROM AUTHOR]

Introduction: Nocturia is a common symptom of lower urinary tract syndrome (LUTS). In previous studies, a close association between LUTS and colorectal inflammation has been reported. However, evidence regarding the association between nighttime urinary frequency and ulcerative colitis (UC) is limited. Herein, we investigated the association between nighttime urinary frequency and clinical outcomes of UC. Methods: We surveyed 287 Japanese patients with UC. A self‐administered questionnaire was used to collect the information on the variables studied. Patients were divided into three groups based on nighttime urinary frequency: (1) no voids, (2) one void, and (3) two or more voids. The assessment of clinical outcomes was based on mucosal healing (MH) and clinical remission (CR). The association between nighttime urinary frequency and prevalence of MH and CR was evaluated using multivariate logistic regression analyses. Results: The prevalence of one nighttime frequency and two or more nighttime frequency in this cohort was 35.5% and 26.8%, respectively. The percentage of MH and CR was 24.7% and 59.2%, respectively. Two or more nighttime frequency (adjusted odds ratio [OR]: 0.31, 95% confidence interval [CI]: 0.13–0.73) was independently and inversely associated with MH. In nonelderly patients (<70 years) and patients in CR, an association between two or more nighttime frequency and MH remained significant (non‐elderly: adjusted OR: 0.27, 95% CI: 0.09–0.72 and only CR: adjusted OR: 0.34, 95% CI: 0.12–0.90). Conclusion: Nighttime urinary frequency was independently and inversely associated with MH in Japanese patients with UC. Nighttime urinary frequency may serve as a complementary physical sign of MH in patients with UC. [ABSTRACT FROM AUTHOR]

Aims: To discuss the role of autocrine/paracrine signaling of urothelial arginine vasopressin (AVP) on mammalian bladder capacities and micturition thresholds, impact of distension on water/urea reabsorption from the bladder, review of the literature to better characterize the central/peripheral effects of AVP, desmopressin (dAVP) toxicity, and urine biomarkers of nocturia. Methods: This review summarizes discussions during an International Consultation on Incontinence‐Research Society 2024 think tank with respect to the role of urothelial AVP in aged individuals with nocturnal polyuria, impact of solute and water reabsorption by the bladder on uninterrupted sleep, central effects of AVP, pharmacological basis of dAVP toxicity, and biomarkers in nocturia/lower urinary tract dysfunction (LUTD) with neurological diseases. Results: Consensus recognized AVP function and pathways in the central nervous system (CNS), pre‐proAVP localized using immunohistochemistry in bladder sections from adult/aged noncancerous human punch biopsies and rodent bladder sections is likely to accelerate the systemic uptake of water and urea from the bladder of anesthetized mice instilled with 3H‐water and 14C‐urea. Mechanisms for charged and uncharged solutes and water transport across the bladder, mechanism of dAVP toxicity, and utility of urine biomarkers in those with neurological diseases/nocturia were determined from literature reviews. Conclusion: Pre‐proAVP is present in human/rodent bladders and may be involved in water reabsorption from bladder that prevents the sensation of fullness for uninterrupted sleep in healthy adults. The mechanism of action of AVP in the CNS was discussed, as was electrolyte/water transport across the bladder, the basis for dAVP toxicity, and feasibility of urine biomarkers to identify nocturia/LUTD with neurological diseases. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine the association between blood lead levels and the prevalence of nocturia in American adults. Methods: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2020, focusing on individuals aged 20 years or older (n = 11,919). Blood lead levels were categorized into two groups (<2 µg/dL and ≥2 µg/dL), and the presence of nocturia was assessed based on questionnaire responses. We used multivariable logistic regression models to explore the association between blood lead levels and nocturia while adjusting for various covariates, including sex, ratio of family income to poverty (RIP), lipid profile, age, body mass index (BMI), race, citizenship, sleep trouble, diabetes, and hypertension. To verify whether certain covariates influence blood lead levels and the risk of nocturia, we conducted subgroup analyses. Results: Of the study participants, 31.70% reported experiencing nocturia. Individuals with higher blood lead levels (≥2 µg/dL) exhibited a higher likelihood of experiencing nocturia compared to those with lower levels (<2 µg/dL) in all three models (Model 1: OR 1.46, 95% CI 1.29–1.66, p < 0.0001; Model 2: OR 1.25, 95% CI 1.09–1.44, p = 0.002; Model 3: OR 1.22, 95%CI 1.06–1.41, p = 0.01). Subgroup analyses revealed that factors such as age, sex, sleep trouble, diabetes, hypertension, BMI, RIP, and race did not affect the association between blood lead levels and the risk of nocturia (P for interaction >0.05). Conclusions: This study reported the correlation between blood lead levels and nocturia. We found that compared to blood lead levels below 2 µg/dL, when lead levels reached or exceeded 2 µg/dL, the risk of nocturia occurrence increased by 22%. Clinical trial registration: This study is based on existing data from a public database and not from a specific clinical trial; hence, clinical registration information is not provided. [ABSTRACT FROM AUTHOR]

Objectives: Desmopressin is widely used for nocturia in patients with nocturnal polyuria. We investigated the continuation rate and adherence for desmopressin in patients with overactive bladder and nocturia using a claims database and evaluated factors that improved adherence. Methods: Patients with nocturia in a Japanese claims database who started desmopressin between September 2019 and July 2021 were evaluated. Drug persistence was assessed using the Kaplan–Meier method for initial prescription of desmopressin. The proportion of days covered (PDC) was also evaluated among patients with prescription persistence. Multivariate analysis was performed using logistic regression analysis to identify factors predicting adherence to desmopressin. Results: The study included 72,888 patients entered into Japan Medical Data Center (JMDC) database between September 2019 and July 2021. For the 236 patients prescribed desmopressin formulations, mean prescription duration was 114 days. Among the total cases, 90 (38.1%) cases were prescribed only once, mean PDC was 0.60, and the number of high‐adherence patients (PDC ≥ 0.80) was 108 (45.8%). Desmopressin prescription doses were fixed in 216 patients and adjusted in 20 patients. Multivariate analysis identified prescription dose adjustment for desmopressin as significantly associated with high PDC. Conclusion: Desmopressin showed a 38% dropout rate after the first dose. However, high medication continuation and high medication adherence rates (PDC) could be maintained with prescription adjustments. Careful patient monitoring and appropriate adjustment of the desmopressin dosage appear to be important factors in improving nocturia. [ABSTRACT FROM AUTHOR]

Objectives: The focus of this research was to explore any potential link between nocturia and the risk of suicidal ideation. Methods: Drawing from the National Health and Nutrition Survey, data relating to 25 241 participants was scrutinized. This included 13 421 individuals identifying as male and 11 820 individuals identifying as female. Participants provided information on nocturia and suicidal ideation via self‐completed questionnaires. To determine if nocturia was independently related to suicidal ideation, a multivariable logistic regression analysis was employed. Analyses were also undertaken separately for adult males and females. Results: It was found that around 3.5% of participants had experienced suicidal ideation. The results indicated that nocturia increased the risk for suicidal ideation in all adult groups (odds ratio [OR] = 1.67, 95% confidence interval[CI]: 1.37−2.03, p < 0.0001), including both males (OR = 1.91, 95% CI: 1.38−2.65, p < 0.001) and females (OR = 1.48, 95% CI: 1.158−1.90, p = 0.002). The risk for suicidal ideation increased with the severity of nocturia, with significant trends observed in adult males (p for trend = 0.04) and adult females (p for trend = 0.01). Additionally, subgroup examination showed a significant interaction between nocturia and educational level in adult males (p for interaction = 0.03). Among adult females, a noteworthy interaction was observed between nocturia and body mass index (p for interaction = 0.02). Conclusion: The research uncovered a connection between nocturia and an elevated risk of suicidal ideation. [ABSTRACT FROM AUTHOR]

Introduction: Nocturnal lower urinary tract symptoms are common in geriatric rehabilitation inpatients but have not been well described. The aim of this study was to compare patient characteristics stratified by self-reported nocturia severity in geriatric rehabilitation inpatients. Methods: The REStORing health of acutely unwell adulTs (RESORT) is an observational, longitudinal, prospective inception cohort of geriatric rehabilitation inpatients who underwent a Comprehensive Geriatric Assessment (CGA) at admission and discharge. Nocturia was captured by item 7 of the American Urology Association Symptom Score (AUASS) and dichotomised as ≤1 void and >1 void at night as per the International Continence Society definition. Differences in demographic, functional, and medical characteristics of the inpatients with and without nocturia >1 were compared. Results: Overall, 641 inpatients completed the nocturia item (mean age 82.6 [SD 7.7] years, 59.9% female). Nocturia occurred >once per night in 57.4%; mean number of episodes was 1.96 (SD 1.38), ranging from 0 to 5. There was no change in nocturia severity between admission and discharge. Daily urinary incontinence, urinary urgency, and comorbid illness were independently associated with multiple nocturia episodes. A history of falls within the last year, difficulty climbing stairs pre-admission, higher faecal incontinence score, impaired quality of life domains, higher levels of anxiety and depression were significantly more common in inpatients with multiple episodes of nocturia compared to no or only one episode of nocturia. Conclusion: Lower urinary tract symptoms, poor functional status and frailty markers were associated with repeated episodes of nocturia. Targeted intervention may reduce the severity of nocturia, with potential to improve sleep quality, impact therapeutic gains and influence discharge destination. [ABSTRACT FROM AUTHOR]

Background Methods Results Discussion Nocturia (waking from sleep at night to void) and chronic insomnia frequently co‐exist in older adults, contributing synergistically to sleep disturbance. Treatments typically target either nocturia or insomnia rather than simultaneously addressing shared mechanisms for these disorders.We conducted a multisite feasibility study to: (1) test and refine a protocol for recruitment, randomization, and assessment of older adults with co‐existing nocturia and insomnia; and (2) examine preliminary changes in outcome measures to inform a future larger, multisite clinical trial. Participants were men and women aged 60 years and older recruited from outpatient clinics, reporting an average of two or more nocturia episodes per night over the past 4 weeks and meeting diagnostic criteria for chronic insomnia disorder. Participants were randomized to receive either integrated cognitive‐behavioral therapy for insomnia and nocturia or a health education control program involving five weekly visits with a trained nurse practitioner interventionist. Outcomes (e.g., nocturia episodes) were measured 1‐week post‐treatment and 4‐month post‐randomization. Descriptive statistics examined the feasibility of outcomes to guide preparations for a future efficacy trial.Of 245 adults screened, 55% were ineligible and 25% declined to participate. Sixty‐one percent of 49 participants who provided informed consent were randomized. Of the 30 participants randomized (mean age = 70.6 years, 60% White), 14 were assigned to integrated cognitive‐behavioral treatment and 16 to the control group. All randomized participants provided 4‐month follow‐up data. At 4 months, mean nightly nocturia episodes decreased by 0.9 (SD 1.0) in the integrated treatment group and by 0.2 (SD 1.2) in the control group compared with baseline.Findings demonstrate the feasibility of recruiting, randomizing, and collecting outcome data from older adults (predominantly male) assigned to an integrated cognitive‐behavioral therapy for coexisting insomnia and nocturia or a health education control program. [ABSTRACT FROM AUTHOR]

Aim: To investigate the role of autonomic nervous system in subpopulations of children with enuresis. Methods: We included 35 children with enuresis, divided in children with (17) and without nocturnal polyuria (18) and 43 healthy controls. For all participants hormones and neurotransmitters were measured. Patients and controls wore a sleep tracker device and children with enuresis underwent a 24 h blood pressure monitoring, nocturnal urine output measurement and uroflowmetry. Results: Children with enuresis had lower than controls copeptin and aldosterone, with the latter being more prominent in patients without nocturnal polyuria. Dopamine was lower in patients without nocturnal polyuria compared with patients with nocturnal polyuria. Children without polyuria experienced episodes only during NREM sleep, whereas in children with polyuria episodes occurred in both REM and NREM sleep. Children with enuresis experienced a non‐dipping phenomenon during sleep which was more prominent in the group without polyuria. Conclusion: In patients with nocturnal polyuria, nocturnal enuresis is associated with sympathetic hyperactivity which results in pressure polyuria and significantly lower systolic dipping during sleep. On the contrary, in children without nocturnal polyuria, it is mostly associated with bladder overactivity due to parasympathetic overstimulation as demonstrated by the NREM‐related enuretic episodes and the lower aldosterone and dopamine levels. [ABSTRACT FROM AUTHOR]

Objectives: Desmopressin improves nocturia frequency; however, reports on its long‐term efficacy and safety are few, and concerns regarding its effect on body composition exist. We thus investigated the efficacy and safety of long‐term desmopressin administration and its effect on body composition. Methods: This retrospective study, conducted at Chikugo City Hospital between August 2020 and December 2022, involved 133 men (mean age, 77.7 years) with nocturnal and persistent nocturia, who were administered an initial dose of 50 μg desmopressin. Efficacy endpoints included nocturnal urinary frequency, nocturnal urinary volume, hours of undisturbed sleep, nocturnal polyuria index, initial nocturnal urinary volume, and daily urinary frequency in a frequency‐volume chart (3 days), before treatment and at 1, 4, 12, 24, and 52 weeks after desmopressin administration. Additionally, the effects of desmopressin on body composition were examined, including blood–brain natriuretic peptide and a chest radiography, before and 52 weeks after administration. Results: Treatment improved most efficacy endpoint evaluation parameters. Around 87.6% of patients showed improved symptoms after 52 weeks compared with those before treatment (score ≤ 3). The blood–brain natriuretic peptide level rose; however, cardiothoracic ratio was unchanged. Conclusion: Long‐term administration of desmopressin is thus effective and safe in older people with nocturnal polyuria, with little effect on body composition. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to evaluate the impact of anterior fibromuscular stroma preserved enucleation (AFSPE) of the prostate on serum testosterone levels in patients with benign prostatic obstruction (BPO) and to explore age‐related differences in postoperative testosterone elevation. Methods: In a retrospective analysis, 304 patients from a pool of 560 who underwent AFSPE at Linkou Chang Gung Memorial Hospital between January 2018 and December 2021 were evaluated. Patients were stratified based on preoperative testosterone levels into low (<3.5 ng/mL) and normal (≥3.5 ng/mL) groups. Serum testosterone levels were measured preoperatively, at 1.5 and 3–6 months postoperatively. Age and other demographic data were analyzed as potential factors influencing testosterone changes. Results: The low‐testosterone group (n = 90) showed significant testosterone increases, from an average of 2.61 ng/mL preoperatively to 3.3 ng/mL at 1.5 months and 3.59 ng/mL at 3–6 months postoperatively (p < 0.0001). The normal‐testosterone group (n = 214) maintained stable testosterone levels at 1.5 months but exhibited a significant rise to 6.06 ng/mL by 3–6 months (p = 0.0079). Older age was inversely associated with postoperative testosterone elevation in both groups. Improvements in nocturia were notable in both groups. Conclusions: AFSPE of the prostate significantly elevates serum testosterone levels in men with BPO, particularly benefiting those initially with low levels. Age is a crucial factor influencing postoperative testosterone changes, indicating that younger patients may benefit more from this intervention. AFSPE offers a promising approach for improving hormonal health in BPO patients, alongside alleviating urinary symptoms. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Materials and Methods Results Conclusions Nocturia impairs the quality of life in patients with type 2 diabetes mellitus. Although sodium glucose co‐transporter 2 inhibitors (SGLT2i) such as tofogliflozin increase urine volume, their impact on nocturia, in conjunction with dietary salt restriction, is less clear.This multicenter, open‐label, randomized, parallel‐group trial included 80 subjects with type 2 diabetes and nocturia. The patients were divided into two groups: one receiving tofogliflozin, the shortest half‐life, without salt restriction, and the other receiving both tofogliflozin and dietary salt restriction. The primary endpoint was nocturia frequency at 12 weeks. The secondary outcomes included changes in daytime urination frequency, urine volume, and home blood pressure.At 12 weeks, there were no significant differences in nocturia changes between both groups. Nocturia frequency did not change in the tofogliflozin without salt restriction group from 1.5 ± 0.8 to 1.3 ± 1.1 times per night (P = 0.297), and significantly decreased from 1.6 ± 1.0 to 1.3 ± 0.7 times per night in the tofogliflozin and dietary salt restriction group (P = 0.049). There was a trend toward increased urine volume and frequency during the daytime in the group with salt restriction, indicating a time‐shift effect of the short half‐life tofogliflozin and salt restriction on urinary time.The frequency of nocturia after tofogliflozin did not increase. Tofogliflozin reduced nocturia when combined with salt restriction. Furthermore, daytime urine volume and frequency showed an increasing trend, suggesting a shift in urine production to daytime hours due to the short half‐life of tofogliflozin. Dietary modifications can enhance the therapeutic benefits of tofogliflozin in managing nocturia in people with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Introduction: The primary objective of this study was to evaluate the impact of vaginal uterosacral plication on urge symptoms and quality of life in a cohort of patients with uterosacral ligament insufficiency and urge symptoms. Methods: A total of 40 female patients were included in the study, and their posterior fornix was supported with gauze to simulate the surgical procedure. Uterosacral plication was applied to patients who experienced a decrease in urinary incontinence, nocturia, a sense of urgency, and a decrease in urge urinary incontinence symptoms or complete recovery. Images of the bladder, bladder neck, urethra, and symphysis pubis were obtained preoperatively and 1 year postoperatively. POP-Q staging was also performed, and patients completed the Overactive Bladder Evaluation Form (OAB-V8) and the Incontinence Impact Questionnaire Short Form (ICIQ-SF). Results: Results from the OAB-V8 questionnaire showed that postoperative nocturia scores improved by 72.1% compared to preoperative scores, and the need to urinate at night and waking up scores improved by 68.3%. The mean bladder neck thickness and the mean detrusor thickness were significantly decreased from 10 to 9.2 (p < 0.0001) and from 8.7 to 6.4 (p < 0.0001), respectively. The ICIQ-SF questionnaire scores showed a 68.4% improvement in urinary incontinence affecting daily life after the operation. Conclusion: This study adds to the clinical evidence that uterosacral ligament support improves symptoms of overactive bladder syndromes, including urgency and nocturia. The use of pelvic floor ultrasound and the apical tamponade test is important in patient selection for the correct indication. [ABSTRACT FROM AUTHOR]

Purpose: To describe the prevalence of nocturia and obstructive sleep apnea (OSA) in a cohort of spinal cord injury (SCI) patients and to describe their association. Additionally, to assess clinical and urodynamic data explaining nocturia and to evaluate the effect of OSA management with continuous positive airway pressure (CPAP). Method: Retrospective analysis of data from patients with SCI followed in a tertiary care rehabilitation center with a specialized sleep and neuro-urology units. All adult SCI patients who underwent urodynamic assessment before polysomnography (PSG) between 2015 and 2023 were eligible. Subjective (nocturia) and objective data (urodynamic data, polysomnography, CPAP built-in software) were collated from the Handisom database (database register no. 20200224113128) and the medical records of SCI patients. Statistical testing used Mann-Whitney test for non-parametric variables, Fisher's exact test for contingency analysis and the Spearman correlation test to assess correlations. A p-value < 0.05 was considered significant. Statistical analyses were performed using GraphPad Prism v9. Results: 173 patients (131 males, 42 females) were included. The majority of patients were paraplegic (n = 111 (64,2%)) and had complete lesions (n = 75 (43,4%)). A total of 100 patients had nocturia (57,5%). The prevalence of OSA (Apnea Hypopnea Index (AHI) ≥ 15/h) in the studied population was 61,9%. No correlation was found between nocturia and OSA. A significant difference was observed between patients with and without nocturia in terms of the presence of neurogenic detrusor overactivity (p = 0,049), volume at the first detrusor contraction (p = 0,004) and the bladder functional capacity (p < 0,001). Conclusion: Nocturia and OSA are highly prevalent in patients with SCI, but no statistical association was found between these two disorders. A prospective study focusing on nocturnal polyuria will be needed to assess the impact of OSA on lower urinary tract symptoms in SCI patients. [ABSTRACT FROM AUTHOR]

Purpose: To establish a foundation for raising awareness and disseminating accurate information about enuresis—one of the most challenging conditions to discuss openly—this paper examines public perceptions of enuresis. Methods: This paper collected title and text data from posts related to enuresis on the top popular online platforms such Naver Cafe in South Korea and Reddit in the United States (US). The data along with the thematic subcommunities where the posts were uploaded, was analyzed and visualized using word cloud, Latent Dirichlet Allocation (LDA) topic modeling, and pyLDAvis. Results: The findings reveal both similarities and differences in how the patients from the 2 countries addressed enuresis online. In both countries, enuresis symptoms were a daily concern, and individuals used online platforms as a space to talk about their experiences. However, South Koreans were more inclined to describe symptoms within region-based communities or mothers' forums, where they exchanged information and shared experiences before consulting a doctor. In contrast, US patients with medical experience or knowledge frequently discussed treatment processes, lifestyle adjustments, and medication options. Conclusions: South Koreans tend to be cautious when selecting and visiting hospitals, often relying on others for advice and preparation before seeking medical attention. Compared to online communities in the US, Korean users are more likely to seek preliminary diagnoses based on nonprofessional opinions. Consequently, it is important to lower the barriers for patients to access professional medical advice to mitigate the potential harm of relying on nonprofessional opinions. Additionally, there is a need to raise awareness so that adults can recognize and address their symptoms in a timely manner. [ABSTRACT FROM AUTHOR]

Introduction and Hypothesis: The objective was to cross-culturally adapt and check for the reliability, internal consistency, and validity of the Nocturia Quality of Life Questionnaire (N-QoL) in Brazilian Portuguese (N-QoL-Br). Methods: The questionnaire was translated according to international guidelines, included forward-translation, back-translation, and consensus among an expert committee. Participants with nocturia completed the Pittsburgh Sleep Quality Index, International Consultation on Incontinence Questionnaire Overactive Bladder, and the General Quality of Life Assessment Questionnaire SF-36 (Medical Outcomes Study 36–Item Short-Form Health Survey), in addition to the N-QoL-Br. The Brazilian version was applied in men and women with nocturia twice within a range of 4 weeks. Psychometric properties such as content validity, construct validity, internal consistency, and test–retest reliability were tested. Results: Content validity was considered adequate. Eighty-four men and women participated in the study. Good internal consistency in the domains and final score of the N-QoL-Br was observed, with Cronbach α greater than 0.9. The test–retest reliability was also high, with an intraclass correlation coefficient greater than 0.9 for the domain sleep/energy, bother/concern, and total score (0.98, 0.98, and 0.97 respectively). Conclusions: The Portuguese version of the N-QoL-Br presents good internal consistency and reproducibility and it can be considered adequate and valid for evaluating the impact of nocturia on the quality of life of men and women in the Brazilian population. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the possible association between androgenic alopecia (AGA) and lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). Methods: A total of 148 patients aged over 45 with LUTS secondary to BPH were prospectively enrolled in this study. According to the Norwood–Hamilton classification, the patients were divided into two groups: AGA (n = 69) and non‐AGA (n = 79). In addition, the cases of AGA were categorized as vertex (n = 39) and frontal baldness (n = 30). The International Prostate Symptom Score (IPSS), uroflowmetry parameters, prostate volume, serum total testosterone (TT), and free and total prostate‐specific antigen concentrations of all patients were assessed and compared between the groups. Correlations between the AGA grade and other variables were also investigated. Results: The serum TT level (354 ± 97.1 vs. 308.6 ± 73.1 ng/dL, p = 0.01), total IPSS (16.1 ± 8.1 vs. 13.4 ± 7.7, p = 0.04), IPSS storage subscore (IPSS‐S) (7.1 ± 3.5 vs. 5.8 ± 3.6, p = 0.03), and number of nocturia episodes (2.5 ± 1.4 vs. 1.8 ± 1.4, p < 0.01) were significantly higher in the AGA group than in the non‐AGA group. There were no significant differences in any of the parameters between the patients with vertex and frontal baldness. The AGA grade showed a significant positive correlation with the TT level (r = 0.407, p = 0.003), IPSS‐S (r = 0.164, p = 0.04), and number of nocturia episodes (r = 0.203, p = 0.015). Conclusions: This study demonstrated that among patients with LUTS, those with AGA had worse symptoms and higher TT levels compared with those without AGA of similar age. Furthermore, the AGA grade was positively correlated with the TT level and storage symptoms. [ABSTRACT FROM AUTHOR]

We aim to investigate perioperative and subacute postoperative complications in patients undergoing LDR or HDR monotherapy for prostate cancer. We hypothesize a low rate of complications, and a favorable toxicity profile in patients treated with HDR compared to LDR. A prospectively collected institutional database was queried for patients treated with HDR or LDR prostate monotherapy between 1998 and 2021. Toxicities were determined per CTCAE. Claims based billing codes were obtained to identify additional events. Events occurring within 4 months of treatment were defined as perioperative or subacute postoperative complications. 759 patients were identified, 446 received LDR with 125I, and 313 received HDR with 192Ir. HDR patients had higher risk features: 75.7% with Gleason score 7+ versus 2.4% of LDR, and 16% with initial PSA 10+ ng/mL versus 2.7% of LDR. Toxicities were mild with the most common being grade 1 GU frequency and nocturia at ∼50%. HDR patients had significantly less grade 2 dysuria (2.6% vs. 9.0%), frequency (4.8% vs. 9.4%), hematuria (1.0% vs. 5.2%), nocturia (3.8% vs. 9.4%), and urinary obstructive symptoms (7.3% vs. 11.2%), all statistically significant. 11 (1.4%) patients had infection requiring antibiotics: 8 (1.8%) from the LDR group and 3 (1%) from the HDR group. Cardiopulmonary events were low at <2% overall, without difference between HDR and LDR. Overall toxicity rates support the safety of prostate brachytherapy. HDR monotherapy is associated with significantly less perioperative and subacute postoperative GU events when compared to LDR monotherapy. Cardiopulmonary events were equally rare in both groups. [ABSTRACT FROM AUTHOR]

Purpose: Sodium-glucose cotransporter-2 (SGLT-2) inhibitors are primarily preferred in patients with type 2 diabetes. The purpose of this paper was to elucidate the effects of SGLT-2 inhibitor use on patients' voiding habits, sleep, and quality of life. Methods: Our study involved patients with type 2 diabetes who had an SGLT2 inhibitor added to their current treatment. The frequency of day-night urination, lower urinary tract symptoms, sleep and quality of life were assessed both prior to initiation of the treatment and during subsequent 1st and 3rd months. Results: The study included 38 women and 34 men. At the third month after SGLT-2 inhibitor had been added, there was a significant decrease in HbA1c, triglyceride and microalbumin levels (p<0.05). There was no increase in voiding frequency (day/night) and there was no difference in the evaluation of lower urinary tract symptoms, but voiding volumes increased in uroflowmetry. When the short form-36 (SF-36) scale was examined, there was a significant improvement in physical function, one of the sub-parameters (p = 0.01). The factor affecting this most, was the improvement in HbA1c. Conclusion: This paper suggests that SGLT-2 inhibitors don't increase voiding frequency and don't cause an increase in lower urinary tract symptoms. [ABSTRACT FROM AUTHOR]

This study retrospectively examines the effectiveness of low-frequency electrical stimulation for addressing nocturia in patients experiencing urinary incontinence after undergoing radical prostatectomy. We reviewed the outcomes of 32 patients who had undergone radical prostatectomy and subsequently experienced urinary incontinence. These patients were divided into the control group (n = 16) who received pelvic floor muscle training and the treatment group (n = 16) who underwent electrophysiological appropriate technique treatment in conjunction with pelvic floor muscle training. We assessed changes in nocturnal voided volume, polyuria index, and nocturia-related quality of life at three different time points: before treatment, after 2 weeks, and at the 3-month follow-up. After 3-month follow-up, both groups exhibit reductions in nocturnal voided volume, and polyuria index compared with baseline and the 2-week mark (p <.05). Treatment group outperformed the control group (p <.05). The quality of life in the treatment group remained consistently high, while the control group did not show a statistically significant difference from baseline (p >.05). The total effective rate was significantly higher in the treatment group (93.75%) than in the control group (75.00%, p =.044). This retrospective analysis suggests that electrophysiological appropriate technique treatment effectively mitigates nocturnal, leading to improved quality of life in patients with urinary incontinence following radical prostatectomy in the near term. [ABSTRACT FROM AUTHOR]

Aims: To investigate changes in subjective and objective sleep quality after desmopressin administration in patients with nocturia due to nocturnal polyuria (NP) using electroencephalography (EEG) and the Pittsburgh sleep quality index (PSQI). Methods: Twenty male patients (≥65 years old) with NP participated in this study. The inclusion criteria were nocturnal frequency ≥ 2, NP index (NPi) ≥ 0.33, first uninterrupted sleep period (FUSP) ≤ 2.5 h, serum sodium concentration ≥ 135 mEq/L, and estimated glomerular filtration rate ≥ 50 mL/min/1.73 m2. Participants were given 50 μg of desmopressin to be taken orally once daily before bed. The primary endpoint was the change in the duration of slow‐wave sleep (nonrapid eye movement sleep stages 3 and 4), as evaluated by EEG 28 days from the baseline. The visual analog scale (VAS) was used as an additional indicator of sleep quality. Results: Analysis of data from 15 participants (median age: 74.0 [70.5, 76.0] years) revealed that from before to after desmopressin administration, significant decreases occurred in the median nocturnal frequency (3.0 [2.0, 4.0] to 1.5 [1.0, 2.0]) and NPi (0.445 [0.380, 0.475] to 0.360 [0.250, 0.430]). Furthermore, FUSP was significantly prolonged from 120.0 (94.0, 150.0) min to 210.0 (203.8, 311.3) min. Although the VAS scores improved, slow‐wave sleep duration and the PSQI global score showed no significant differences (68.50 [47.50, 75.50] and 48.00 [38.00, 66.50]; 5.0 [5.0, 10.0] and 7.0 [5.0, 9.0] min, respectively). Conclusion: Oral administration of 50 μg desmopressin improved nocturnal frequency and FUSP in older individuals with NP but did not significantly enhance sleep quality. In older adults, decreased nighttime urinary frequency may enhance quality of life; however, its influence on objective sleep quality may be limited. [ABSTRACT FROM AUTHOR]

Background: The relationship between waist circumference and nocturia has not been previously studied. This study investigated the association between waist circumference and the occurrence of nocturia in adults. Methods: We analyzed data from the National Health and Nutrition Examination Survey covering 2005–2020, encompassing 6287 adults aged ≥20. Nocturia was defined as the need to urinate two or more times during the night. First, we compared baseline characteristics between the nocturia and non‐nocturia groups. Subsequently, we used multivariate logistic regression analysis to investigate the relationship between waist circumference and nocturia prevalence. We also employed restricted cubic spline analysis to study the potential nonlinear correlation between waist circumference and the prevalence of nocturia. Recognizing the baseline data's heterogeneity based on nocturia prevalence, we conducted subgroup analyses according to age, sex, body mass index (BMI), and ethnicity. Results: Our findings indicated that females, individuals aged ≥50, citizens, Non‐Hispanic Black, those with lower education levels (high school or less), higher BMIs, lower family income‐to‐poverty ratios, higher waist circumference, hypertension, and diabetes were more likely to experience nocturia. Compared with individuals in the lowest waist circumference quartile (Q1), those in the higher quartiles (Q4) exhibited an increased risk of nocturia in Model 1 (Q4, OR:2.00, 95% CI:1.64, 2.45, p < 0.0001). These results remained consistent after adjusting for covariates in models 2 and 3. A restricted cubic spline analysis suggested a linear association between waist circumference and nocturia (P for nonlinearity = 0.066). Subgroup analyses based on age, sex, BMI, and ethnicity revealed no significant differences in the interaction tests between waist circumference and nocturia (P for interaction = 0.437, 0.331, 0.121, and 0.889, respectively), indicating that these baseline characteristics did not influence the association. Conclusions: Our findings indicated an association between increased waist circumference and a higher prevalence of nocturia. Knowledge of this association reinforces the importance of lifestyle modifications in maintaining a healthy waist circumference and informs public health strategies to address other potential risk factors for nocturia. [ABSTRACT FROM AUTHOR]

INTRODUCTION AND HYPOTHESIS: Lower urinary tract symptoms (LUTS) are common among adolescent girls. Physical activity (PA) has been implicated as both a risk (high-impact PA) and protective factor (low-impact, moderate to vigorous intensity PA) for LUTS in adult women, but its role in adolescent girls is unclear. This study investigated the prospective association between physical activity and LUTS risk in adolescent girls. METHODS: The sample comprised 3,484 female participants in the Avon Longitudinal Study of Parents and Children. Multivariate logistic regression models were used to examine daily minutes of moderate to vigorous PA (MVPA) at ages 11 and 15 years in relation to LUTS at ages 14 and 19 respectively. MVPA was assessed by 7-day accelerometer data. LUTS were assessed by questionnaire. MVPA were analyzed as continuous (minutes/day) and categorical variables (

Men have a significantly shorter life expectancy compared to women, with disparities further magnified among those from disadvantaged backgrounds. Non-communicable diseases (NCDs) constitute a large proportion of the health disparity between men and women. Up to 40% of the chronic disease burden in men could be mitigated through risk factor management or early intervention. This disparity is often attributed to the engagement with primary and preventive healthcare by men which is influenced by health literacy, accessibility of care and socio-economic status. The manuscript proposes that genitourinary symptoms, specifically erectile dysfunction (ED) and lower urinary tract symptoms (LUTS), are sentinel indicators of chronic diseases or their risk factors in men. LUTS and ED share risk factors with major chronic disorders like cardiovascular disease, diabetes, and obesity, and are associated with depression and obstructive sleep apnea. Both ED and LUTS are meaningful to men and can motivate seeking care, providing healthcare providers an opportunity for preventative measures and early treatment. Such an approach also ameliorates the LUTS and ED symptoms and substantially improves quality of life. We advocate for a targeted approach that uses ED and nocturia as entry points for engaging men in healthcare. This involves public health education to raise awareness about the significance of these symptoms and encouraging healthcare providers to actively inquire about them during consultations. By addressing these symptoms, healthcare practitioners can better identify and treat underlying chronic conditions early, potentially reducing morbidity and mortality among men and helping to narrow the sex related health outcome disparities between genders.

Purpose To establish a foundation for raising awareness and disseminating accurate information about enuresis—one of the most challenging conditions to discuss openly—this paper examines public perceptions of enuresis. Methods This paper collected title and text data from posts related to enuresis on the top popular online platforms such Naver Cafe in South Korea and Reddit in the United States (US). The data along with the thematic subcommunities where the posts were uploaded, was analyzed and visualized using word cloud, Latent Dirichlet Allocation (LDA) topic modeling, and pyLDAvis. Results The findings reveal both similarities and differences in how the patients from the 2 countries addressed enuresis online. In both countries, enuresis symptoms were a daily concern, and individuals used online platforms as a space to talk about their experiences. However, South Koreans were more inclined to describe symptoms within region-based communities or mothers’ forums, where they exchanged information and shared experiences before consulting a doctor. In contrast, US patients with medical experience or knowledge frequently discussed treatment processes, lifestyle adjustments, and medication options. Conclusions South Koreans tend to be cautious when selecting and visiting hospitals, often relying on others for advice and preparation before seeking medical attention. Compared to online communities in the US, Korean users are more likely to seek preliminary diagnoses based on nonprofessional opinions. Consequently, it is important to lower the barriers for patients to access professional medical advice to mitigate the potential harm of relying on nonprofessional opinions. Additionally, there is a need to raise awareness so that adults can recognize and address their symptoms in a timely manner.