Nocturia is a common clinical condition that severely affects patients'quality of life and is strongly associated with complications such as depression,cognitive dysfunction,mood disorders,and fall-related injurie...Nocturia is a common clinical condition that severely affects patients'quality of life and is strongly associated with complications such as depression,cognitive dysfunction,mood disorders,and fall-related injuries.The etiology of nocturia is complex and mainly includes increased total urine output,nocturnal polyuria,decreased functional bladder capacity,sleep disorders,and confounding factors.In recent years,with the in-depth study of the pathophysiological mechanisms of nocturia,the diagnostic methods have been updated,and the application of tools such as the frequency volume chart,bladder capacity index,and bladder diary have provided an important basis for the precise identification of the etiology.Behavior modification has been widely used in clinical practice as a first-line treatment.In addition,advances in pharmacotherapy have provided new directions for the management of nocturia,and the efficacy and safety ofα-blockers,cholinergic receptor antagonists,adrenergicβ-agonists,desmopressin,melatonin,and other medications have been gradually validated.However,there are still some limitations in the existing studies,especially in the long-term safety and efficacy of drug therapy as well as the mechanism of action still need to be further explored.This article reviews the latest research advances in nocturia,aiming to provide clinicians with diagnostic and therapeutic strategies based on evidencebased medicine,and to promote the standardization and individualization of nocturia management.展开更多
Objective To evaluate the efficacy and safety of desmopressin on frequency and urgency in female patients with overactive bladder(OAB)and nocturia.Methods A selective database search was conducted to validate the effe...Objective To evaluate the efficacy and safety of desmopressin on frequency and urgency in female patients with overactive bladder(OAB)and nocturia.Methods A selective database search was conducted to validate the effectiveness of desmopressin in patients with OAB and nocturia.Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were utilised.The meta-analysis included 378 women(five studies)with OAB.The clinical outcomes and adverse events were analysed.Results The treatment strategy of all the studies included can be divided into three categories:(1)The effect of desmopressin compared with baseline,(2)desmopressin compared with placebo,and(3)desmopressin and anticholinergic combination versus desmopressin monotherapy.There was a significant(50%)reduction in nocturia and urgency episodes after using desmopressin alone.Combined desmopressin and anticholinergic led to a decrease in the frequency of nocturia voids when only using anticholinergic(65%vs.33.2%).The time increased in the middle to the first nightly voids in the combination arm(65.11 min;p=0.045).The mean incidence(standard deviation)of leak-free episodes was higher under desmopressin than under placebo in the first 4 h(62%[35%]vs.48%[40%])and in the first 8 h(55%[37%]vs.40%[41%]).The safety profile was comparable between treatments.Conclusion Available data indicate that desmopressin is efficacious in significantly reducing nighttime urine production,episodes of nocturia,and urgency episodes.The affectivity of the combination therapy was very high with least side effects for the treatment of OAB/nocturnal polyuria.展开更多
The elderly people are prone to be affected by quality of life (QOL) by nocturia becoming the multiple times. A purpose of this study was to determine it about a factor associated with the night urination. This survey...The elderly people are prone to be affected by quality of life (QOL) by nocturia becoming the multiple times. A purpose of this study was to determine it about a factor associated with the night urination. This survey was conducted in 2015 as a cross-sectional study. Anonymous, self-administered questionnaires were used to prevent individuals from being identified. The analysis subjects were 699 elderly people with the nocturia which belonged to club of the aged 65 years or older. Those with nocturia were placed in the Nocturia-1 group if they reported experiencing nocturia once per night or in the Nocturia- ≥ 2 group if they reported experiencing nocturia two or more times per night. We analyzed the relationships between the characteristics, lower urinary tract symptoms, and opportunities to go outdoors in the Nocturia-1 and Nocturia- ≥ 2 groups based on sex using the χ2 test. In addition, to investigate the factors that influence the change from nocturia once per night to two or more times per night, we performed logistic regression analysis using the χ2 test on the characteristics and lower urinary tract symptoms that showed significant differences separately for men and women. Among the men, factors with a significant positive relation-ship were age, diabetes mellitus, lower back pain, daytime frequency, and urinary urgency. Among the women, factors with a significant positive relationship were age, requiring support 1-requiring long-term care 2, urinary urgency, and feeling of incomplete emptying. It was suggested that the life of elderly people improved by nocturia not increasing.展开更多
Patients with suspected OSA were examined using PSG.They were divided into two groups based on the presence of nocturia.Nocturia was defined as a patient who needed to void at least once.Apneaehypopnea index(AHI)was e...Patients with suspected OSA were examined using PSG.They were divided into two groups based on the presence of nocturia.Nocturia was defined as a patient who needed to void at least once.Apneaehypopnea index(AHI)was employed to classify patients according to degrees of severity:AHI<5 events/h,5 events/hAHI<15 events/h,15 events/hAHI<30 events/h,and AHI30 events/h,defined as normal,mild OSA,moderate OSA,and severe OSA,respectively.Demographic variables,PSG parameters,International Prostate Symptom Scores(IPSSs),and quality of life scores due to urinary symptoms were analyzed.Results:In total 140 patients,114 patients had OSA(48 had mild OSA;34 had moderate OSA;and 32 had severe OSA)and 107 patients had nocturia.The total IPSS was significantly higher in nocturia patients in all groups except the group of severe OSA patients.With the increasing severity of OSA,more correlated factors related to nocturia were determined.In mild OSA patients,nocturia related to increased age(p=0.025),minimum arterial blood oxygenation saturation(p=0.046),and decreased AHI of non-rapid eye movement(p=0.047),AHI of total sleep time(p=0.010),and desaturation index(p=0.012).In moderate OSA patients,nocturia related to increased age(p<0.001),awake time(p=0.025),stage 1 sleep(p=0.033),and sleep latency(p=0.033),and decreased height(p=0.044),weight(p=0.025),and sleep efficiency(p=0.003).In severe OSA patients,nocturia related to increased weight(p=0.011),body mass index(p=0.009),awake time(p=0.008),stage 1 sleep(p=0.040),arousal number(p=0.030),arousal index(p=0.013),periodic limb movement number(p=0.013),and periodic limb movement index(p=0.004),and decreased baseline arterial blood oxygenation saturation(p=0.046).Conclusion:Our study revealed that there were more correlated factors related to nocturia with increasing severity of OSA.This study helps in clinical education and treatment for OSA patients with different severity.展开更多
OBJECTIVE: To estimate the effects of nocturia on quality of life (QoL) and to assess the associated effects of sleep problems. Background: Nocturnal urination (nocturia) is such a commonplace occurrence in the lives ...OBJECTIVE: To estimate the effects of nocturia on quality of life (QoL) and to assess the associated effects of sleep problems. Background: Nocturnal urination (nocturia) is such a commonplace occurrence in the lives of many older adults that it is frequently overlooked as a potential cause of sleep disturbance. Methods: The current study was carried out to assess the prevalence of nocturia in elderly males and its impact on sleep quality and QoL. The study enrolled 200 elderly males aged 60 years old and above. All participants were recruited from geriatric clubs in Cairo. All participants in the study were subjected to: comprehensive geriatric assessment, American Urological Association (AUA) score used to measure the severity of nocturia ,assessment of sleep quality using Pittsburgh Sleep Quality Index (PSQI) and assessment of QoL using “SF-12 Short Form Health Survey”. Results: The study showed that the prevalence of nocturia in elderly males aged ≥60 years old was 68% with significant association between nocturia and diabetes mellitus, heart failure, stroke, prostatism, recurrent UTI and diuretic use. As regard sleep quality, the current study showed that the prevalence of poor sleep in the studied subjects is 70.5% with significant association between nocturia and poor sleep quality. Nocturia significantly affects sleep latency, sleep efficiency and daytime dysfunction, high significantly affecting sleep disturbance. Also diabetes mellitus, ischemic heart disease, heart failure, prostatism, recurrent UTI, osteoarthritis and diuretic use are significantly associated with poor sleep quality. As regard quality of life, the current study showed significant association between nocturia and physical and mental health components of HRQL in the univariate analysis. But after multivariate analysis, nocturia is not an independent risk factor for poor quality of life. Nocturia affects QoL through its effect on sleep quality which is an independent risk factor for poor physical and mental health components of QoL. Conclusion: Nocturia may lead to sleep insufficiency and consequently to a decrease in mental and physical health. Patients who consult a doctor for nocturia should thus be treated adequately. In addition, it is worthwhile for doctors to routinely check if patients’ who contact them for sleep problems also have nocturia.展开更多
Introduction: Nocturia is categorized into many categories. Each category requires different approaches and treatment. We aimed to obtain data regarding nocturia, classified into categories according to its pathogenes...Introduction: Nocturia is categorized into many categories. Each category requires different approaches and treatment. We aimed to obtain data regarding nocturia, classified into categories according to its pathogenesis, in Thai patients. Methods: We reviewed 133 medical records and voiding diaries of the patients who attended a urologic clinic in a tertiary teaching hospital during year 2009-2010 with nocturia problems. Those data were analyzed to sort these nocturia patients into the appropriate categories. Results: There were a total of 133 patients, consisting of 94 males (70.1%) and 39 females (29.9%). Overall mean age was 64.74 ± 25.85 years. There was no statistically difference between the two genders (Male 65.94 ± 24.56 years vs. Female 61.87 ± 28.24 years, p = 0.10). Among these, 71 patients (53.4%) had nocturnal polyuria. Almost all patients (132 patients, 99.2%) met the criteria for diminished global/nocturnal bladder capacity. The younger patients (less than 40 years) were found to have more severe clinical symptoms than the older patients (6 from 8 or 75% vs. 46 from 125 or 36%, p = 0.032). Seventy patients (52.6%) met the criteria of Mixed NP and Diminished. There were 32 patients (24.1%) found in the group of Global polyuria. Only one patient was classified as isolated nocturnal polyuria and none as isolated global polyuria. Conclusion: Nocturnal polyuria and global polyuria are not uncommon conditions and most of these patients might have concomitant diminished bladder capacity for which investigation or simultaneous treatment may be needed to gain the best treatment result.展开更多
To examine the efficacy of the melatonin receptor agonist ramelteon for nocturia, it was compared with zolpidem, a conventional non-benzodiazepine hypnotic. A total of 50 patients with nocturia (32 urinations/night) w...To examine the efficacy of the melatonin receptor agonist ramelteon for nocturia, it was compared with zolpidem, a conventional non-benzodiazepine hypnotic. A total of 50 patients with nocturia (32 urinations/night) were enrolled. Subjects assigned odd numbers or even numbers were respectively prescribed 8 mg of ramelteon (n = 27;mean age: 75 years) or 5 mg of zolpidem (n = 23;mean age: 73 years) once a day before sleeping for 4 weeks. The daytime and nighttime frequencies of urination, as well as the results of global self-assessment by the patients, were compared between the two groups before and after 4 weeks of treatment. Both ramelteon and zolpidem caused a significant decrease of nocturia to about once per night after 4 weeks. The global self-assessment rating at 4 weeks was “good” or “fair” for more patients in the zolpidem group than in the ramelteon group, while the rating was “excellent” or “no change” for more patients in the ramelteon group. There were no serious adverse events in either group. Ramelteon was safe and effective for nocturia, achieving similar results to zolpidem. However, responders and non-responders to ramelteon were more clearly distinguished. Ramelteon might be effective for patients with sleep disturbance and nocturia because of low melatonin levels. Therefore, as diagnostic therapy for identification of nocturia caused by sleep disturbance and melatonin deficiency, ramelteon should be administered to patients who do not respond to alpha-1 antagonists and/or anticholinergic agents.展开更多
We investigated the efficacy of oral desmopressin in the treatment of adult nocturia. In an analytical study between 2007-2009 in Zahedan-Iran, Thirty patients ≥55 years with verified nocturia (≥two voids/night) wer...We investigated the efficacy of oral desmopressin in the treatment of adult nocturia. In an analytical study between 2007-2009 in Zahedan-Iran, Thirty patients ≥55 years with verified nocturia (≥two voids/night) were enrolled. Patients with a history of an obstructive cause of nocturia, those with diseases getting worse by the anti-diuretic affect of desmopressin and those with well-defined curable causes (e.g. cystitis) were excluded. Patients received 0.2 mg of oral desmopressin at bed time for a period of 3 weeks. p < 0.05 was taken as the significant level. All 30 patients enrolled completed the trial. Fourteen (47 %) patients receiving desmopressin had fewer than half the number of nocturnal voids relative to base line (p < 0.001). The mean number of nocturnal voids decreased from 4.6 to 2.4 (p < 0.001). Fatigue (10%), headache (3%) and dizziness (3%) were reported. All adverse events were of mild intensity and there were no instances of hyponatremia. Oral desmopressin is an effective treatment in patients with nocturia and is well-tolerated.展开更多
Introduction: Nocturia has a multifactorial etiology, and its diagnostic approach involves, in addition to medical history and physical examination, the use of a bladder diary to define the pathophysiological mechanis...Introduction: Nocturia has a multifactorial etiology, and its diagnostic approach involves, in addition to medical history and physical examination, the use of a bladder diary to define the pathophysiological mechanisms present in each case. Methods: This study investigated the prevalence of nocturia, its mechanisms, and associated factors in women with lower urinary tract symptoms attending two urogynecology clinics in the state of Rio de Janeiro, Brazil. Anamnesis, physical examination, and a 24-hour bladder diary were conducted. Two definitions of nocturia were considered: one or more nighttime voids and two or more nighttime voids. Mann-Whitney and Chi-square tests were used, with p-value ≤ 0.05 considered significant. Results: A total of 133 participants were included. The majority were aged 60 years or older (61.4%) and had three or more comorbidities (66.7%), with systemic arterial hypertension being the most prevalent (59.1%). Of the total participants, 54 (41.4%) completed the bladder diary. Among those with one or more nighttime voids (70.7%), the prevalence of nocturnal polyuria was 69.1%, reduced nocturnal bladder capacity was 17.3%, and global polyuria was 12.9%. Among participants with two or more nighttime voids (56.4%), the prevalences were respectively 68.2%, 19.1%, and 13.6%. Among the mechanisms, associations were found only with global polyuria, namely: use of insulin, body mass index and tobacco consumption. An association was also found between recurrent urinary tract infection and global polyuria in participants with two or more nighttime voids. Conclusions: The prevalence of nocturia was higher than that reported in general population studies and specialized services for lower urinary tract symptoms. Nocturnal polyuria was the most prevalent mechanism. Associations were observed between the use of insulin, body mass index, tobacco consumption, and recurrent urinary tract infection with global polyuria. No associations were found between any clinical or demographic variables and nocturnal polyuria or reduced nocturnal bladder capacity.展开更多
目的：比较轮值夜班的护士与非轮值夜班的护士排尿日记的差异。方法：选择2014年1月至6月期间一直在北京大学人民医院住院病房工作的女性护士共58名,入选的护士年龄为20～43岁,其中28名护士在这半年内轮值夜班,作为夜班组,平均年龄为（2...目的：比较轮值夜班的护士与非轮值夜班的护士排尿日记的差异。方法：选择2014年1月至6月期间一直在北京大学人民医院住院病房工作的女性护士共58名,入选的护士年龄为20～43岁,其中28名护士在这半年内轮值夜班,作为夜班组,平均年龄为（26.75±4.11）岁,另外30名护士在这半年内无需轮值夜班,作为白班组,平均年龄为（27.80±5.60）岁。在这半年的最后1周记录其排尿日记,并要求在记录期间保证每日摄水量控制在1 500～2 000 m L。比较两组护士正常睡眠时的夜尿情况,并比较相应的8 h时间段内排尿情况的差异。结果：值夜班的护士与值白班的护士相比,正常睡眠时夜间排尿量[125 m L（0～660 m L）vs.0 m L（0～340 m L）]及夜间排尿次数[0.5次（0～2.4次）vs.0次（0～2次）]明显增加（P〈0.05）,而且在连续1周的记录中,夜班护士在值完夜班后的2天内夜间排尿量比值夜班前明显增加（P〈0.01）。夜班组护士与白班组护士相比,在下午的8 h时间段（2 pm—10 pm）内,排尿量[（542.35±204.66）m L vs.（675.62±256.09）m L]和排尿次数[（2.24±0.69）次vs.（2.91±0.73）次]明显减少（P〈0.05）。在夜间的8 h时间段（10 pm—6 am）内,夜班组护士与白班组护士相比,排尿量[（309.74±162.74）m L vs.（199.38±153.98）m L,P=0.01]和排尿次数[（1.31±0.52）次vs.（0.82±0.55）次,P〈0.01）]均明显增加。结论：轮值夜班明显影响护士的排尿,增加夜尿量及夜尿次数。展开更多
文摘Nocturia is a common clinical condition that severely affects patients'quality of life and is strongly associated with complications such as depression,cognitive dysfunction,mood disorders,and fall-related injuries.The etiology of nocturia is complex and mainly includes increased total urine output,nocturnal polyuria,decreased functional bladder capacity,sleep disorders,and confounding factors.In recent years,with the in-depth study of the pathophysiological mechanisms of nocturia,the diagnostic methods have been updated,and the application of tools such as the frequency volume chart,bladder capacity index,and bladder diary have provided an important basis for the precise identification of the etiology.Behavior modification has been widely used in clinical practice as a first-line treatment.In addition,advances in pharmacotherapy have provided new directions for the management of nocturia,and the efficacy and safety ofα-blockers,cholinergic receptor antagonists,adrenergicβ-agonists,desmopressin,melatonin,and other medications have been gradually validated.However,there are still some limitations in the existing studies,especially in the long-term safety and efficacy of drug therapy as well as the mechanism of action still need to be further explored.This article reviews the latest research advances in nocturia,aiming to provide clinicians with diagnostic and therapeutic strategies based on evidencebased medicine,and to promote the standardization and individualization of nocturia management.
文摘Objective To evaluate the efficacy and safety of desmopressin on frequency and urgency in female patients with overactive bladder(OAB)and nocturia.Methods A selective database search was conducted to validate the effectiveness of desmopressin in patients with OAB and nocturia.Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were utilised.The meta-analysis included 378 women(five studies)with OAB.The clinical outcomes and adverse events were analysed.Results The treatment strategy of all the studies included can be divided into three categories:(1)The effect of desmopressin compared with baseline,(2)desmopressin compared with placebo,and(3)desmopressin and anticholinergic combination versus desmopressin monotherapy.There was a significant(50%)reduction in nocturia and urgency episodes after using desmopressin alone.Combined desmopressin and anticholinergic led to a decrease in the frequency of nocturia voids when only using anticholinergic(65%vs.33.2%).The time increased in the middle to the first nightly voids in the combination arm(65.11 min;p=0.045).The mean incidence(standard deviation)of leak-free episodes was higher under desmopressin than under placebo in the first 4 h(62%[35%]vs.48%[40%])and in the first 8 h(55%[37%]vs.40%[41%]).The safety profile was comparable between treatments.Conclusion Available data indicate that desmopressin is efficacious in significantly reducing nighttime urine production,episodes of nocturia,and urgency episodes.The affectivity of the combination therapy was very high with least side effects for the treatment of OAB/nocturnal polyuria.
文摘The elderly people are prone to be affected by quality of life (QOL) by nocturia becoming the multiple times. A purpose of this study was to determine it about a factor associated with the night urination. This survey was conducted in 2015 as a cross-sectional study. Anonymous, self-administered questionnaires were used to prevent individuals from being identified. The analysis subjects were 699 elderly people with the nocturia which belonged to club of the aged 65 years or older. Those with nocturia were placed in the Nocturia-1 group if they reported experiencing nocturia once per night or in the Nocturia- ≥ 2 group if they reported experiencing nocturia two or more times per night. We analyzed the relationships between the characteristics, lower urinary tract symptoms, and opportunities to go outdoors in the Nocturia-1 and Nocturia- ≥ 2 groups based on sex using the χ2 test. In addition, to investigate the factors that influence the change from nocturia once per night to two or more times per night, we performed logistic regression analysis using the χ2 test on the characteristics and lower urinary tract symptoms that showed significant differences separately for men and women. Among the men, factors with a significant positive relation-ship were age, diabetes mellitus, lower back pain, daytime frequency, and urinary urgency. Among the women, factors with a significant positive relationship were age, requiring support 1-requiring long-term care 2, urinary urgency, and feeling of incomplete emptying. It was suggested that the life of elderly people improved by nocturia not increasing.
基金support from Tungs’Taichung Metroharbor Hospital(grant number#TTMHH-109R0048 to Stella Chin-Shaw Tsai).
文摘Patients with suspected OSA were examined using PSG.They were divided into two groups based on the presence of nocturia.Nocturia was defined as a patient who needed to void at least once.Apneaehypopnea index(AHI)was employed to classify patients according to degrees of severity:AHI<5 events/h,5 events/hAHI<15 events/h,15 events/hAHI<30 events/h,and AHI30 events/h,defined as normal,mild OSA,moderate OSA,and severe OSA,respectively.Demographic variables,PSG parameters,International Prostate Symptom Scores(IPSSs),and quality of life scores due to urinary symptoms were analyzed.Results:In total 140 patients,114 patients had OSA(48 had mild OSA;34 had moderate OSA;and 32 had severe OSA)and 107 patients had nocturia.The total IPSS was significantly higher in nocturia patients in all groups except the group of severe OSA patients.With the increasing severity of OSA,more correlated factors related to nocturia were determined.In mild OSA patients,nocturia related to increased age(p=0.025),minimum arterial blood oxygenation saturation(p=0.046),and decreased AHI of non-rapid eye movement(p=0.047),AHI of total sleep time(p=0.010),and desaturation index(p=0.012).In moderate OSA patients,nocturia related to increased age(p<0.001),awake time(p=0.025),stage 1 sleep(p=0.033),and sleep latency(p=0.033),and decreased height(p=0.044),weight(p=0.025),and sleep efficiency(p=0.003).In severe OSA patients,nocturia related to increased weight(p=0.011),body mass index(p=0.009),awake time(p=0.008),stage 1 sleep(p=0.040),arousal number(p=0.030),arousal index(p=0.013),periodic limb movement number(p=0.013),and periodic limb movement index(p=0.004),and decreased baseline arterial blood oxygenation saturation(p=0.046).Conclusion:Our study revealed that there were more correlated factors related to nocturia with increasing severity of OSA.This study helps in clinical education and treatment for OSA patients with different severity.
文摘OBJECTIVE: To estimate the effects of nocturia on quality of life (QoL) and to assess the associated effects of sleep problems. Background: Nocturnal urination (nocturia) is such a commonplace occurrence in the lives of many older adults that it is frequently overlooked as a potential cause of sleep disturbance. Methods: The current study was carried out to assess the prevalence of nocturia in elderly males and its impact on sleep quality and QoL. The study enrolled 200 elderly males aged 60 years old and above. All participants were recruited from geriatric clubs in Cairo. All participants in the study were subjected to: comprehensive geriatric assessment, American Urological Association (AUA) score used to measure the severity of nocturia ,assessment of sleep quality using Pittsburgh Sleep Quality Index (PSQI) and assessment of QoL using “SF-12 Short Form Health Survey”. Results: The study showed that the prevalence of nocturia in elderly males aged ≥60 years old was 68% with significant association between nocturia and diabetes mellitus, heart failure, stroke, prostatism, recurrent UTI and diuretic use. As regard sleep quality, the current study showed that the prevalence of poor sleep in the studied subjects is 70.5% with significant association between nocturia and poor sleep quality. Nocturia significantly affects sleep latency, sleep efficiency and daytime dysfunction, high significantly affecting sleep disturbance. Also diabetes mellitus, ischemic heart disease, heart failure, prostatism, recurrent UTI, osteoarthritis and diuretic use are significantly associated with poor sleep quality. As regard quality of life, the current study showed significant association between nocturia and physical and mental health components of HRQL in the univariate analysis. But after multivariate analysis, nocturia is not an independent risk factor for poor quality of life. Nocturia affects QoL through its effect on sleep quality which is an independent risk factor for poor physical and mental health components of QoL. Conclusion: Nocturia may lead to sleep insufficiency and consequently to a decrease in mental and physical health. Patients who consult a doctor for nocturia should thus be treated adequately. In addition, it is worthwhile for doctors to routinely check if patients’ who contact them for sleep problems also have nocturia.
文摘Introduction: Nocturia is categorized into many categories. Each category requires different approaches and treatment. We aimed to obtain data regarding nocturia, classified into categories according to its pathogenesis, in Thai patients. Methods: We reviewed 133 medical records and voiding diaries of the patients who attended a urologic clinic in a tertiary teaching hospital during year 2009-2010 with nocturia problems. Those data were analyzed to sort these nocturia patients into the appropriate categories. Results: There were a total of 133 patients, consisting of 94 males (70.1%) and 39 females (29.9%). Overall mean age was 64.74 ± 25.85 years. There was no statistically difference between the two genders (Male 65.94 ± 24.56 years vs. Female 61.87 ± 28.24 years, p = 0.10). Among these, 71 patients (53.4%) had nocturnal polyuria. Almost all patients (132 patients, 99.2%) met the criteria for diminished global/nocturnal bladder capacity. The younger patients (less than 40 years) were found to have more severe clinical symptoms than the older patients (6 from 8 or 75% vs. 46 from 125 or 36%, p = 0.032). Seventy patients (52.6%) met the criteria of Mixed NP and Diminished. There were 32 patients (24.1%) found in the group of Global polyuria. Only one patient was classified as isolated nocturnal polyuria and none as isolated global polyuria. Conclusion: Nocturnal polyuria and global polyuria are not uncommon conditions and most of these patients might have concomitant diminished bladder capacity for which investigation or simultaneous treatment may be needed to gain the best treatment result.
文摘To examine the efficacy of the melatonin receptor agonist ramelteon for nocturia, it was compared with zolpidem, a conventional non-benzodiazepine hypnotic. A total of 50 patients with nocturia (32 urinations/night) were enrolled. Subjects assigned odd numbers or even numbers were respectively prescribed 8 mg of ramelteon (n = 27;mean age: 75 years) or 5 mg of zolpidem (n = 23;mean age: 73 years) once a day before sleeping for 4 weeks. The daytime and nighttime frequencies of urination, as well as the results of global self-assessment by the patients, were compared between the two groups before and after 4 weeks of treatment. Both ramelteon and zolpidem caused a significant decrease of nocturia to about once per night after 4 weeks. The global self-assessment rating at 4 weeks was “good” or “fair” for more patients in the zolpidem group than in the ramelteon group, while the rating was “excellent” or “no change” for more patients in the ramelteon group. There were no serious adverse events in either group. Ramelteon was safe and effective for nocturia, achieving similar results to zolpidem. However, responders and non-responders to ramelteon were more clearly distinguished. Ramelteon might be effective for patients with sleep disturbance and nocturia because of low melatonin levels. Therefore, as diagnostic therapy for identification of nocturia caused by sleep disturbance and melatonin deficiency, ramelteon should be administered to patients who do not respond to alpha-1 antagonists and/or anticholinergic agents.
文摘We investigated the efficacy of oral desmopressin in the treatment of adult nocturia. In an analytical study between 2007-2009 in Zahedan-Iran, Thirty patients ≥55 years with verified nocturia (≥two voids/night) were enrolled. Patients with a history of an obstructive cause of nocturia, those with diseases getting worse by the anti-diuretic affect of desmopressin and those with well-defined curable causes (e.g. cystitis) were excluded. Patients received 0.2 mg of oral desmopressin at bed time for a period of 3 weeks. p < 0.05 was taken as the significant level. All 30 patients enrolled completed the trial. Fourteen (47 %) patients receiving desmopressin had fewer than half the number of nocturnal voids relative to base line (p < 0.001). The mean number of nocturnal voids decreased from 4.6 to 2.4 (p < 0.001). Fatigue (10%), headache (3%) and dizziness (3%) were reported. All adverse events were of mild intensity and there were no instances of hyponatremia. Oral desmopressin is an effective treatment in patients with nocturia and is well-tolerated.
文摘Introduction: Nocturia has a multifactorial etiology, and its diagnostic approach involves, in addition to medical history and physical examination, the use of a bladder diary to define the pathophysiological mechanisms present in each case. Methods: This study investigated the prevalence of nocturia, its mechanisms, and associated factors in women with lower urinary tract symptoms attending two urogynecology clinics in the state of Rio de Janeiro, Brazil. Anamnesis, physical examination, and a 24-hour bladder diary were conducted. Two definitions of nocturia were considered: one or more nighttime voids and two or more nighttime voids. Mann-Whitney and Chi-square tests were used, with p-value ≤ 0.05 considered significant. Results: A total of 133 participants were included. The majority were aged 60 years or older (61.4%) and had three or more comorbidities (66.7%), with systemic arterial hypertension being the most prevalent (59.1%). Of the total participants, 54 (41.4%) completed the bladder diary. Among those with one or more nighttime voids (70.7%), the prevalence of nocturnal polyuria was 69.1%, reduced nocturnal bladder capacity was 17.3%, and global polyuria was 12.9%. Among participants with two or more nighttime voids (56.4%), the prevalences were respectively 68.2%, 19.1%, and 13.6%. Among the mechanisms, associations were found only with global polyuria, namely: use of insulin, body mass index and tobacco consumption. An association was also found between recurrent urinary tract infection and global polyuria in participants with two or more nighttime voids. Conclusions: The prevalence of nocturia was higher than that reported in general population studies and specialized services for lower urinary tract symptoms. Nocturnal polyuria was the most prevalent mechanism. Associations were observed between the use of insulin, body mass index, tobacco consumption, and recurrent urinary tract infection with global polyuria. No associations were found between any clinical or demographic variables and nocturnal polyuria or reduced nocturnal bladder capacity.
文摘目的：比较轮值夜班的护士与非轮值夜班的护士排尿日记的差异。方法：选择2014年1月至6月期间一直在北京大学人民医院住院病房工作的女性护士共58名,入选的护士年龄为20～43岁,其中28名护士在这半年内轮值夜班,作为夜班组,平均年龄为（26.75±4.11）岁,另外30名护士在这半年内无需轮值夜班,作为白班组,平均年龄为（27.80±5.60）岁。在这半年的最后1周记录其排尿日记,并要求在记录期间保证每日摄水量控制在1 500～2 000 m L。比较两组护士正常睡眠时的夜尿情况,并比较相应的8 h时间段内排尿情况的差异。结果：值夜班的护士与值白班的护士相比,正常睡眠时夜间排尿量[125 m L（0～660 m L）vs.0 m L（0～340 m L）]及夜间排尿次数[0.5次（0～2.4次）vs.0次（0～2次）]明显增加（P〈0.05）,而且在连续1周的记录中,夜班护士在值完夜班后的2天内夜间排尿量比值夜班前明显增加（P〈0.01）。夜班组护士与白班组护士相比,在下午的8 h时间段（2 pm—10 pm）内,排尿量[（542.35±204.66）m L vs.（675.62±256.09）m L]和排尿次数[（2.24±0.69）次vs.（2.91±0.73）次]明显减少（P〈0.05）。在夜间的8 h时间段（10 pm—6 am）内,夜班组护士与白班组护士相比,排尿量[（309.74±162.74）m L vs.（199.38±153.98）m L,P=0.01]和排尿次数[（1.31±0.52）次vs.（0.82±0.55）次,P〈0.01）]均明显增加。结论：轮值夜班明显影响护士的排尿,增加夜尿量及夜尿次数。
