Nocturia, nocturnal polyuria and secondary nocturnal voiding.

Getting up once to the toilet at night is normal. Getting up more than once may be abnormal. Potential causes include: nocturia, which is bladder related; nocturnal polyuria, which is cardiac in origin; and being awake for a variety of reasons that are not linked to the bladder. Bladder problems, therefore, are not always the reason for frequency in micturition at night and treatment will only be effective if the correct cause and/or causes are identified. The most useful investigation to help with diagnosis is a frequency volume chart linked to an assessment identifying causes of secondary nocturnal voiding and nocturnal polyuria. Getting up to the toilet at night will not always be successfully treated by anticholinergics. Charting is the key to diagnosis, appropriate interventions and successful outcomes. This article will focus on working definitions, prevalence, causes, investigations and treatment options for nocturia, nocturnal polyuria and secondary nocturnal voiding.