Development of TANGO, a novel screening tool to identify co-existing causes of nocturia

Ms Georgie Rose1, Dr Wendy Bower1, Ms Claire Ervin1, Dr D.Michael Whishaw1

1Royal Melbourne Hospital (Royal Park Campus), Parkville, Australia




The objective of this study was to develop a metric to assist clinicians to identify co-existing causes of nocturia in their patients. As we wished to Target Aetiology of Nocturia to Guide optimal Outcomes, the metric was entitled TANGO.



Individual variables carrying a significant risk association with nocturia of >1/night were identified from a systematic review. Discriminating items from validated and reliable measurement tools were identified and compiled into a self-completed 57-item questionnaire, the TANGO Long Form (LF). 252 patients with nocturia who were presenting for care at a tertiary-level hospital, completed the LF. Data analyses, alongside clinical and empirical criteria informed item reduction to produce the TANGO Short Form (SF). This 23-item screening tool was subject to test-retest reliability in 40 inpatients at the same health service.



Significant interactions were identified between voiding at night and metabolic, cardiovascular, hormonal, mental health, sleep and inflammatory changes. Univariate analyses of the LF data revealed 22 items to be significantly associated with nocturia frequency >=2/night (p< 0.05). The final regression model for high frequency nocturia contained 7 independent variables: general health, pain, time to first nocturia, sudden urge, urge leakage, depression, hours in bed and sleep quality. Test-retest reliability of the SF demonstrated substantial to excellent agreement (Kappa >0.6 to >0.8 respectively) for all bar two variables.



The TANGO SF guides clinicians  in identifying co-existing causes of nocturia and has the potential to smooth inequalities associated with current assessment of this symptom in a broad range of patients