Nocturnal polyuria versus overactive bladder in nocturia☆
Section snippets
Nocturnal polyuria
The increased production of urine at night experienced in NP is offset by lowered daytime urine production, such that the 24-hour urine volume remains normal.6 A reason for this diurnal change is thought to be a disruption of the diurnal variation in secretion of arginine vasopressin (AVP). AVP, normally secreted in a diurnal pattern, is partly responsible for regulation of urine production.18 Because AVP increases the resorption of water from the renal tubule, higher concentrations of AVP
Nocturia caused by diminished nocturnal bladder capacity
Nocturia caused by diminished NBC is of 2 general types: decreased FBC and decreased NBC. In both conditions, NUV exceeds bladder capacity and the patient is awakened by the need to void because the bladder does not hold enough. The FBC is the largest volume voided as recorded in the micturition diary. If the FBC is less than NUV, nocturia ensues.35
To quantify NBC, several terms need to be defined: nocturia index (Ni) and the NBC index (NBCi). The Ni is NUV divided by FBC; the first morning
Mixed causes for nocturia
Many patients with nocturia are found to have a combination of NP and low NBC. We term this a mixed origin of nocturia. A recent study37 of nocturia in elderly patients determined that older patients with nocturia tend to have higher NUVs and lower FBCs than their counterparts without nocturia. However, the ratio between NUV and FBC (otherwise known as the Ni38) allowed a more significant discrimination of the origin of nocturia in elderly patients than either variable alone: In patients with
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Cited by (58)
Nocturia: The Complex Role of the Heart, Kidneys, and Bladder
2020, European Urology FocusCitation Excerpt :RN caused by diminished nocturia bladder capacity (NBC) is of two general types: decreased FBC and decreased NBC. In both conditions, the nocturnal volume urinated exceeds the bladder capacity and the patient is awakened by the need to void because the bladder capacity is not sufficient [11]. The relation between RN and OAB has been investigated in several studies [12–14].
Chiropractic management of pubic symphysis shear dysfunction in a patient with overactive bladder
2014, Journal of Chiropractic MedicineCitation Excerpt :Prostatic disease and neurogenic bladder may also lead to wakening from sleep and voiding. Taking diuretic medications, consuming beverages including caffeine or alcohol, and excessive fluid intake prior to retiring may also lead to nocturia.10 The underlying pathophysiologic conditions that account for nocturia can be described in 4 broad categories: (1) nocturnal polyuria (nocturnal urine overproduction); (2) low nocturnal bladder capacity; (3) mixed (a combination of 1 and 2); and (4) polyuria (abnormally high daily urine output).10
Prevalence, incidence, and resolution of nocturnal polyuria in a longitudinal community-based study in older men: The Krimpen study
2013, European UrologyCitation Excerpt :Therefore, we feel that medical treatment, if any, had a negligible impact on the resolution of NP. Another explanation for fluctuation in the prevalence of NP might lie in the multifactorial etiology [4–6]. For example, excessive fluid intake can easily be resolved without the need of a health care professional.
Melatonin and melatonin receptor agonists in the treatment of nocturia: A systematic review
2024, Neurourology and Urodynamics
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Jeffrey P. Weiss is a study investigator funded by, and a paid consultant to, Ferring Pharmaceuticals, Copenhagen, Denmark.