Nocturia resident survival guide
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahmoud Sakr, M.D. [2]
Overview
This section provides a short and straight to the point overview of the disease or symptom. The first sentence of the overview must contain the name of the disease.
Causes
Common Causes
- Hormonal imbalance which may leads to:
- Global polyuria
- Nocturnal polyuria
- Vesical problems which includes bladder storage disorders:
- Benign prostatic hyperplasia (BPH)
- Neurogenic bladder dysfunction
- Learned voiding dysfunction
- Anxiety disorders
Diagnosis
| Urinary frequency volume chart | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Reduced urinary frequency | {{{24hr Polydipsia}}} | {{{ 24HR Urine volume }}} | {{{ Nocturnal urine volume }}} | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
| May have reduced bladder capacity | {{{ Increased fluid intake }}} | {{{ Global polyuria }}} | {{{Nocturnal polyuria }}} | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
Check for primary or secondary bladder disorders which include:
| {{{ Check for:
| XX | XX | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
Treatment
Shown below is an algorithm summarizing the treatment of Nocturia according the the [...] guidelines.
| {{{ -}}} | Start with Conservative Treatment:
- First, educate the patient about the nature of his disease by drawing flowcharts or simple diagrams. - Restrict fluid intake at night. - avoid sugary food and coffee before bedtime -Manage use of diuretics -If previous illness leads to nocturia, then treating that illness will surely help. It's important to treat diabetes, an enlarged prostate (BPH), congestive heart failure, obstructive sleep apnea (OSA), and/or high blood pressure. Changing the timing and dose of prescribed medication may also help sometimes. Always look into the patient's previous records. -Scheduled voiding at timed intervals, varying from 15 min to 1 h, based on the patient’s own frequency or incontinence intervals - Make a record of their voiding during day and night. -Do pelvic muscle strengthening exercises (contracting pelvic floor muscles) to suppress urgency. -Elastic compression stockings prevent fluid build-up. So the use of compression stockings can be helpful. -Increase compliance determines the success of treatment, | ||||||||||||||||||||||||||||||||
| Successful | Failed | ||||||||||||||||||||||||||||||||
| -Follow-up visits are scheduled every 1 to 2 weeks if the patient's condition is stable and he is responding to conservative therapy | |||||||||||||||||||||||||||||||||
| At some point Patients stops responding to behavioral modifications | -Continue conservative treatments till it works | If lifestyle changes alone don't help with your nocturia, some medicines may help. | |||||||||||||||||||||||||||||||
| -Start Medical Intervention. -If patient experience bed-wetting, he can keep himself and his bed dry by using different products For example, waterproof mattress covers, absorbent briefs and skincare products. | Medicines to help the kidneys produce less urine. For example, Desmopressin,
Anticholinergic medicines to treat bladder muscle problems. for example: Darifenacin, Oxybutynin, Tolterodine. a-Adrenergic agonists: Increases urethral closure pressure. it includes Ephedrine and Pseudoephedrine. Antispasmodic like Baclofen Botulinum toxin Tricyclic antidepressant: Imipramine, Amitriptyline Diuretic medicines to regulate urine production and high blood pressure. For example, Bumetanide, Furosemide | ||||||||||||||||||||||||||||||||
| Some patients who are refractory to behavioral and pharmacologic therapies respond to FES. Functional electrical stimulation (FES) increasing pelvic floor muscle and urethral striated muscle contractility. | |||||||||||||||||||||||||||||||||
Do's
- The content in this section is in bullet points.
Don'ts
- The content in this section is in bullet points.