Lower Urinary Tract Dysfunction
Initial management of nocturia

Lena (61 years old)

Lena is a 61-year-old school teacher and has 3 healthy children. Since 5 months, she needs to wake up at night to void 2-3 times. It has a significant impact on the quality of her sleep and the quality of her life. During the day, she occasionally loses urine with urgency before reaching the toilet. Bladder training and advice on fluid management did not help.


Medical history: No comorbidities.
Clinical examination: Gynaecological: normal. No signs of stress urinary incontinence. No other abnormalities. Weight: 60 kg.
Urinalysis: Normal.
Bladder scan: No post void residual.
Bladder diary: Frequency: day 7x, night 3x. Voided volumes: 30-250 ml. 24h diuresis: 1,450 ml (12% during the night). Urine leakage: 2x, small amount.

Which medication is the most appropriate to treat her nocturia complaint?