The discrepancy between European Association of Urology (EAU) guidelines and daily practice in the evaluation and management of nocturia: results of a Dutch survey

• Published in: World journal of urology 2019-11, Vol.37 (11), p.2517-2522
• Main Authors: Rahnama’i, M. S., Vrijens, D. M. J., Hajebrahimi, S., van Koeveringe, G. A., Marcelissen, T. A. T.
• Format: Article
• Language: English
• Subjects: Antagonists; Apnea; Congestive heart failure; Cross-Sectional Studies; Desmopressin; Diabetes; Diabetes mellitus; Europe; Female; Guideline Adherence - statistics & numerical data; Health Care Surveys; Humans; Male; Management; Medicine; Medicine & Public Health; Nephrology; Netherlands; Nocturia - diagnosis; Nocturia - therapy; Oncology; Original Article; Polyuria; Practice Guidelines as Topic; Practice Patterns, Physicians; Sleep; Sleep disorders; Societies, Medical; Urology
• ISSN: 0724-4983; 1433-8726
• DOI: 10.1007/s00345-019-02638-5

Background and objective In addition to the evaluation of voiding symptoms, in the evaluation of patients with nocturia, one should also consider other related causes such as sleep disorders, obstructive sleep apnoea (OSAS), diabetes and heart failure. In this study, we have aimed to assess the current knowledge and implementation of the EAU guidelines regarding nocturia in common urological practice in the Netherlands. Setting and participants In a national cross-sectional survey distributed among 450 urologists and urology residents in the Netherlands, the implementation of the recommendations of the European Association of Urology (EAU) guidelines on nocturia evaluation and management was studied. Results and limitations This survey revealed that only some aspects of the EAU guidelines are applied in the daily clinical practice and that some important parts are not. For example, only a minority asks about alcohol consumption and symptoms suggestive for diabetes or OSAS. In addition, a majority reported to use a bladder diary for 1–3 days instead of for a minimum of 3 days as recommended by the EAU guidelines. In the management of nocturia, a trial of timed diuretic therapy is only reported by a minority, whereas the use of beta-3 antagonists, which is not mentioned in the guidelines, is applied by a large majority. Desmopressin recommended for nocturnal polyuria is prescribed by two-third of Dutch urologists. Conclusions These observations mandate better education and campaigns to raise the awareness on the EAU-guideline recommendations for nocturia.