Lower Urinary Tract Dysfunction
Initial management of nocturia

Jon (54 years old)

Jon, a 54-year-old lab technician, 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 13x, night 4x. Voided volumes: 200-400 ml. 24h diuresis: 5,290 ml (33% during the night). Fluid intake 5 l.


What is the most appropriate initial treatment choice for this patient?