Research Progress on the Precise Classification and Individualized Diagnosis and Treatment of Nocturia.

Abstract

Background: Nocturia is a common urological symptom whose prevalence increases progressively with age. It not only impairs sleep and quality of life but also increases the risk of adverse events, including falls and fractures. Clinical management remains limited by inadequate evaluation of underlying etiologies, imprecise phenotyping, and suboptimal therapeutic responses.

Summary: To facilitate standardized diagnostic and therapeutic strategies, we reviewed and summarized relevant literature published over the past decade. Focusing on four major subtypes, nocturnal polyuria (NP), diminished bladder capacity (DBC), global polyuria (GP), and sleep disorder-predominant nocturia (SDP), we developed a clinical framework integrating precise assessment, phenotypic classification, and individualized treatment. This review compares the pathophysiological mechanisms underlying different phenotypes, identifies the voiding diary as the cornerstone of assessment, and proposes a streamlined three-step clinical phenotyping algorithm. A stepwise treatment strategy tailored to different subtypes is outlined, incorporating psychological counseling, lifestyle modification, pharmacotherapy, physical therapy, and surgery.

Key messages: This review provides a reference for the precise and individualized management of nocturia and highlights the potential future roles of digital assessment and multidisciplinary care.