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Thuytkl/Nocturia Sandbox

Nocturia (derived from Latin nox, night, and Greek [τα] ούρα, urine), also called nycturia (Greek νυκτουρία), is defined by the International Continence Society (ICS) as “the complaint that the individual has to wake at night one or more times to void.”[1] Nocturia has only recently been recognized as a separate clinical entity within the lower urinary tract symptom complex.Cite error: A <ref> tag is missing the closing </ref> (see the help page).

Global Polyuria

Global polyuria is defined as urine outputs of greater than 40 mL/kg/24 hours. Global polyuria is most commonly caused by excessive intake of fluids seen in patients with polydipsia and diabetes insipidus. [2]

Nocturnal Polyuria

Nocturnal polyuria is defined as night-time urine volumes of greater than 20% and 33% of the 24 hour voided volume in adults and patients over 65 years of age, respectively. Nocturnal polyuria affects about 80% of patients with nocturia. [2]

Bladder Storage Disorders

Bladder storage disorders are defined as any factors that increase the frequency of small volume voids. These factors are usually related to lower urinary tract symptoms (LUTS) that affect the capacity of the bladder. [2]

Mixed Etiology

Definition

Causes

Polyuria

Diabetes mellitus

  • Insulin dependent (Type I)
  • Insulin independent (Type II)

Diabetes insipidus

  • Pituitary
  • Renal
  • Gestational
  • Primary polydipsia (psychogenic, dipsogenic, or iatrogenic)

Nocturnal Polyuria

Water diuresis

  • Circadian defect in secretion or action of antiduretic hormone
  • Primary (idiopathic)
  • Secondary (excessive evening intake of fluid, caffeine, alcohol)

Solute/water diuresis

  • Congestive heart failure
  • Autonomic dysfunction
  • Sleep apnea syndrome
  • Renal insufficiency
  • Estrogen deficiency

Bladder Storage

Reduced functional bladder capacity (e.g. significant postvoid residual)
 Reduced nocturnal bladder capacity
Detrusor overactivity

  • Neurogenic (e.g. multiple sclerosis)
  • Non-neurogenic

Bladder hypersensitivity

  • Bladder outlet obstruction with postvoid residual urine
  • Urogenital aging

Diagnosis

  • Vasopressin Concentration Test

Management

Lifestyle Changes

  • Limit caffeine and coffee
  • Fluid restriction
  • diuretics

Surgery

  • Transurethral prostatectomy/transurethral incision

Pharmacotherapy

  • Desmopressin - definition and characteristics

Impact

  • on society
  • on productivity
  • on lifestyle

See also

References

  1. ^ van Kerrebroeck, P (2002). "The standardisation of terminology in nocturia: Report from the standardisation Sub-committee of the International Continence Society". Neurourol Urodyn. 21: 179–83.
  2. ^ a b c Cite error: The named reference Prince was invoked but never defined (see the help page).

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684373/

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