Lower Urinary Tract Dysfunction
Initial management of nocturia

Michael (54 years)

Michael, a 54-year-old football coach, is referred to the urologist for persisting storage LUTS. He mentions that he needs to go to the toilet very frequently both during the day and night.


Medical history: Diabetes (controlled). Obesity (weight 80 kg, length 163 cm, BMI 30). Hypercholesterolaemia (statins).

Clinical examination: DRE: normal. No signs of peripheral oedema.

Urinalysis: Normal.

Uroflow studies: Normal, no post void residual.

Bladder diary: Frequency: day 7x, night 3x. Voided volumes: 200-400 ml. 24h diuresis: 2,500 ml (33% during the night). Normal fluid intake.

Which initial treatment would be most appropriate in this case?