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Meta-Analysis
. 2016 Aug;70(2):372-81.
doi: 10.1016/j.eururo.2016.02.014. Epub 2016 Feb 20.

Incidence and Remission of Nocturia: A Systematic Review and Meta-analysis

Jori S Pesonen  1 , Rufus Cartwright  2 , Altaf Mangera  3 , Henrikki Santti  4 , Tomas L Griebling  5 , Alexey E Pryalukhin  6 , Jarno Riikonen  7 , Riikka M Tähtinen  8 , Arnav Agarwal  9 , Johnson F Tsui  10 , Camille P Vaughan  11 , Alayne D Markland  11 , Theodore M Johnson 2nd  11 , Riikka Fonsell-Annala  12 , Charlie Khoo  13 , Teuvo L J Tammela  7 , Yoshitaka Aoki  14 , Anssi Auvinen  15 , Diane Heels-Ansdell  16 , Gordon H Guyatt  17 , Kari A O Tikkinen  18
Affiliations
Free article
Meta-Analysis

Incidence and Remission of Nocturia: A Systematic Review and Meta-analysis

Jori S Pesonen et al. Eur Urol. 2016 Aug.
Free article

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.

Keywords: Epidemiology; Incidence; Lower urinary tract symptoms; Meta-analysis; Meta-regression; Nocturia; Remission; Systematic review.

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