Abstract
The theme of the symposium was the London tube, which is famous for the expression ‘Mind the gap’; the symposium theme was tweaked to ‘Mind the debate’ with three debates that focussed on gaps in understanding of nocturia. Nocturia is a multifactorial medical condition with several components including nocturnal polyuria, reduced bladder capacity, and sleep disorders. Nocturia can be caused by comorbidities such as heart failure, diabetes mellitus, and sleep apnoea. The debate discussed that nocturia is a highly prevalent medical condition that increases with age and affects both men and women. Nocturia disturbs sleep and can seriously affect a patient’s quality of life. The condition also increases mortality by making patients more prone to falls and to fracture the head of the femur. Nocturia results in poor concentration at work and can lead to a loss of productivity. Assessments for nocturia were considered including frequency volume charts (FVC), urine albumin to creatinine ratios, peripheral oedema examinations, bladder diaries, and ultrasound testing. One treatment for nocturia has been desmopressin, but the risks of hyponatraemia have led to a reluctance to prescribe, especially in populations aged >65 years, who are at particular risk if treated with too high a dose. Recently NOCDURNA®, a gender-specific low-dose oral lyophylisate formulation of desmopressin, has been developed (50 µg/day in men and 25 µg/day in women). At these low doses desmopressin was shown to be effective and well-tolerated in two Phase III trials and to provide rapid and sustained improvements in nocturia and quality of life. The formulation is suitable for individuals >65 years old, but the advice is that they require sodium monitoring before initiating the treatment, in the first week of treatment (4-8 days) and again at one month after treatment initiation.