1
|
Jia Y, Ca J, Yang F, Dong X, Zhou L, Long H. Association between family income to poverty ratio and nocturia in adults aged 20 years and older: A study from NHANES 2005-2010. PLoS One 2024; 19:e0303927. [PMID: 38768158 PMCID: PMC11104595 DOI: 10.1371/journal.pone.0303927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 05/02/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Nocturia, the most common lower urinary tract symptom (LUTS), significantly impacts socioeconomic factors and individuals' quality of life and is closely related to many diseases. This study utilized data from NHANES 2005-2010 to explore the relationship between family income to poverty ratio (PIR) and the presence of nocturia symptoms in adults aged 20 or older in the United States. METHODS Data from the National Health and Nutrition Examination Survey (NHANES) in 2005-2010, including 6,662 adults aged 20 or older, were utilized for this cross-sectional study. The baseline data was used to display the distribution of each characteristic visually. Multiple linear regression and smooth curve fitting were used to study the linear and non-linear correlations between PIR and nocturia. Subgroup analysis and interaction tests were conducted to examine the stability of intergroup relationships. RESULTS Out of the 6,662 adult participants aged 20 or older, 1,300 households were categorized as living in poverty, 3,671 households had a moderate income, and 1,691 households were classified as affluent. Among these participants, 3,139 individuals experienced nocturia, representing 47.12% of the total, while 3,523 individuals were nocturia-free, constituting 52.88% of the total population. After adjusting for all other covariates, it was found that PIR was significantly negatively correlated with nocturia (OR: 0.875, 95%CI: 0.836-0.916 P<0.0001). This trend persisted when PIR was divided into three groups (PIR <1, PIR 1-4, PIR > 4) or quartiles. There was a non-linear negative correlation between PIR and nocturia. CONCLUSION Our findings indicated that lower PlR was associated with a higher risk of nocturia in adults aged 20 or older in the United States. These findings highlight the importance of considering socioeconomic factors in preventing and managing nocturia. Nonetheless, further exploration of the causal nexus between these factors was precluded due to the constraints of a cross-sectional design.
Collapse
Affiliation(s)
- Yangtao Jia
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, 315040, People’s Republic of China
| | - Jiacheng Ca
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, 315040, People’s Republic of China
| | - Fangzheng Yang
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, 315040, People’s Republic of China
| | - Xinke Dong
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, 315040, People’s Republic of China
| | - Libin Zhou
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, 315040, People’s Republic of China
| | - Huimin Long
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, 315040, People’s Republic of China
| |
Collapse
|
2
|
Wang J, Zhang A, Ye M, Zhang C. Association between TV and/or video time and nocturia in adults: An analysis of the National Health and Nutrition Examination Survey. Neurourol Urodyn 2024; 43:628-637. [PMID: 38379416 DOI: 10.1002/nau.25406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/11/2024] [Accepted: 01/18/2024] [Indexed: 02/22/2024]
Abstract
AIMS This study aimed to examine the correlation between television (TV) and/or video viewing time and the occurrence of nocturia in adults. METHODS An analysis of data from the National Health and Nutrition Examination Survey for 2011-2016 was conducted, involving 13 294 adults aged 20 and older. The main outcome was specified as nocturia, which refers to the requirement of urinating two or more times during the night. Initially, baseline characteristics were contrasted between individuals with and without nocturia. The effects of TV and/or video viewing time on nocturia were further explored using multivariable logistic regression models. To acknowledge the variation in baseline data regarding the prevalence of nocturia, subgroup analyses were performed. RESULTS Adjusted multivariate analysis revealed that individuals in the group with the longest TV and/or video viewing time had a significantly 48% higher risk of experiencing nocturia compared to those with the shortest TV and/or video viewing time. The results of subgroup analyses revealed no significant differences in the interaction tests between TV and/or video viewing time and nocturia. CONCLUSIONS Our research showed that individuals who spent 5 or more hours a day watching TV and/or videos were significantly more likely to develop nocturia.
Collapse
Affiliation(s)
- Junwei Wang
- Department of Urology, Wenling Hospital Affiliated to Wenzhou Medical University (The First People's Hospital of Wenling), Taizhou, Zhejiang, China
| | - Aiwei Zhang
- Department of Ultrasound, Wenling Hospital Affiliated to Wenzhou Medical University (The First People's Hospital of Wenling), Taizhou, Zhejiang, China
| | - Miaoyong Ye
- Department of Urology, Wenling Hospital Affiliated to Wenzhou Medical University (The First People's Hospital of Wenling), Taizhou, Zhejiang, China
| | - Cunming Zhang
- Department of Urology, Wenling Hospital Affiliated to Wenzhou Medical University (The First People's Hospital of Wenling), Taizhou, Zhejiang, China
| |
Collapse
|
3
|
Chen M, He W, Cai S, Chen Z, Ye H, Jin Z, Lv X. Association of nocturia with cardiovascular and all-cause mortality: a prospective cohort study with up to 31 years of follow-up. Front Public Health 2023; 11:1292362. [PMID: 38186694 PMCID: PMC10768185 DOI: 10.3389/fpubh.2023.1292362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/05/2023] [Indexed: 01/09/2024] Open
Abstract
Background Nocturia is a highly prevalent and under-considered condition and impacts the quality of life for many individuals. The long-term impact of nocturnal voiding on mortality, especially mortality from cardiovascular disease, remains unknown. The current study aimed to evaluate the relationship of nocturnal voiding episodes with cardiovascular and all-cause mortality among adults in the United States. Methods This is a prospective cohort study of a nationally representative sample of 13,862 U.S. adults aged 20 years or older who participated in the National Health and Nutrition Examination Survey III (1988-1994). Nighttime urination frequency was reported during an in-house interview. All-cause and cause-specific mortality were ascertained by linking to National Death Index mortality data through December 31, 2019. The associations of nocturia with cardiovascular and all-cause mortality were estimated using weighted Cox proportional hazards regression models. Results Throughout a median follow-up of 26.7 years, 5,029 deaths were reported, comprising 1,720 deaths from cardiovascular disease. In the fully adjusted model, participants who reported once, twice, and three or more times nocturnal voiding episodes have a higher risk of cardiovascular mortality (HR1, 1.22 [95% CI, 0.997-1.49], HR2, 1.47 [95% CI, 1.13-1.91], and HR ≥ 3, 1.96 [95% CI, 1.52-2.53]) as well as all-cause mortality (HR1, 1.12 [95% CI, 0.90-1.39], HR2, 1.54 [95% CI, 1.23-1.93], and HR ≥ 3, 2.48 [95% CI, 1.81-3.40]), compared to those without nocturia, and heart disease-specific mortality (HR1, 1.33 [95% CI, 1.08-1.64], HR2, 1.62 [95% CI, 1.25-2.10], and HR≥3, 2.07 [95% CI, 1.61-2.67]). Nevertheless, there was no significant relationship between the number of nocturia episode changes and stroke-specific mortality. Conclusion Nocturia was associated with a significantly augmented risk of overall and heart disease-specific mortality in a dosage-dependent manner. Early recognition and taking precautions may benefit individuals with nocturia by promoting quality of life and cardiac health.
Collapse
Affiliation(s)
- Min Chen
- Wuhan University of Science and Technology Medical College, Wuhan, China
| | - Wangan He
- Department of Cardiology, China Resources and Wisco General Hospital, Wuhan University of Science and Technology, Wuhan, China
| | - Shaoqian Cai
- Department of Cardiology, China Resources and Wisco General Hospital, Wuhan University of Science and Technology, Wuhan, China
| | - Zhi Chen
- Wuhan University of Science and Technology Medical College, Wuhan, China
| | - Huarong Ye
- China Resources and Wisco General Hospital, Wuhan University of Science and Technology, Wuhan, China
| | - Zhigang Jin
- Department of Cardiology, China Resources and Wisco General Hospital, Wuhan University of Science and Technology, Wuhan, China
| | - Xuexiang Lv
- Department of Cardiology, China Resources and Wisco General Hospital, Wuhan University of Science and Technology, Wuhan, China
| |
Collapse
|
4
|
Bryophyllum pinnatum and Improvement of Nocturia and Sleep Quality in Women: A Multicentre, Nonrandomised Prospective Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2023; 2023:2115335. [PMID: 36798727 PMCID: PMC9928503 DOI: 10.1155/2023/2115335] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/07/2022] [Accepted: 11/24/2022] [Indexed: 02/10/2023]
Abstract
Nocturia is a pathologic condition that significantly affects the quality of sleep. The aetiology of nocturia is multifactorial, and the evidence available on its management remains limited. Besides behavioural measures, validated pharmaceutical treatment options exist but are, however, associated with marked side effects. Prospective clinical studies with tablets prepared from the leaf press juice of the plant Bryophyllum pinnatum revealed a tendency towards reduction of micturition in patients with overactive bladder (OAB) and several improvements in sleep quality. These observations are in part supported by in vitro and in vivo data. In the present study, we investigated the effectiveness of Bryophyllum 50% chewable tablets in the treatment of nocturia and associated sleep disorders. Altogether, 49 women with idiopathic OAB and nocturia of ≥2 voids/night were treated with Bryophyllum 50% tablets for 3 weeks (350 mg chewable tablets, dosage 0-0-2-2 oral tablets; WELEDA AG, Arlesheim, Switzerland). Nocturia, voiding volumes at night (ml), quality of life, sleep quality, and daily sleepiness were assessed before and after treatment with a 3-day micturition diary, the International Consultation on Incontinence evaluating overactive bladder and related impact on quality of life (QoL) [ICIQ-OAB], the Pittsburgh Sleep Quality Index (PSQI), and the Epworth Sleepiness Scale (ESS), respectively. The age of the study population was 68.5 ± 11.6 y. After treatment, nocturia diminished from 3.2 ± 1.4 to 2.3 ± 1.3 (P < 0.001) and the PSQI score decreased from 7.7 ± 3.7 to 6.6 ± 3.4 (P=0.004). Urgency, the ICIQ score, and the ESS lowered significantly, and the micturition volume showed a tendency to increase. No serious adverse drug reactions were reported, and compliance was good. The results show a beneficial effect on the nocturnal voids and sleep quality of women with OAB. Bryophyllum 50% tablets can be regarded as a well-tolerated alternative in the treatment of nocturia and broaden the repertoire of standard management.
Collapse
|
5
|
Lv K, Wu Y, Huang S, Luo Z, Lai W, Meng Q, Xia X, Lv C, Hao X, Song T, Yuan Q. Age and metabolic syndrome are associated with unsatisfactory improvement in nocturia after holmium laser enucleation of the prostate. Front Surg 2023; 9:1063649. [PMID: 36704512 PMCID: PMC9871621 DOI: 10.3389/fsurg.2022.1063649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 12/12/2022] [Indexed: 01/11/2023] Open
Abstract
Objective To investigate the association between age, metabolic syndrome (MetS) and improvement in nocturia in patients with benign prostate hyperplasia (BPH) receiving holmium laser enucleation of the prostate (HoLEP). Methods The retrospective study was conducted on patients treated for BPH using HoLEP between January 2021 and May 2022. Lower urinary tract symptoms (LUTS) were measured before surgery and at 3 months postoperatively using the International Prostate Symptom Score (IPSS). The criteria of the Adult Treatment Panel III (ATP III) were adopted to diagnose the MetS. Unsatisfactory improvement in nocturia was defined as <50% reduction in nocturia from baseline on the IPSS. Results One hundred and seventy-five patients were eventually enrolled, with a median age of 69 years (IQR: 63/73). Unsatisfactory improvement in nocturia was reported in 95 patients (54%) after HoLEP. These patients were older (73; IQR: 67/79 vs. 66; IQR: 60/71, P < 0.001) and more likely to present with higher postoperative total (6; IQR: 4/9 vs. 3; IQR:2/5, P < 0.001), voiding (1; IQR: 0/3 vs. 1; IQR: 0/2, P = 0.017), and storage (4; IQR: 3/6 vs. 2; IQR: 1/4, P < 0.001) IPSS when compared to patients with satisfactory improvement in nocturia. Overall, 63 of 175 (36%) patients were diagnosed with MetS and of these, 44 (70%) reported unsatisfactory improvement in nocturia (P = 0.002) after HoLEP. Multivariate analysis revealed that age (OR = 1.117, 95% CI: 1.068-1.169, P < 0.001) and MetS (OR = 3.613, 95% CI: 1.727-7.562, P = 0.001) were independent risk factors for unsatisfactory improvement in nocturia after HoLEP. Conclusion Our findings suggest that increased age and MetS were associated with unsatisfactory improvement in nocturia in patients with BPH after HoLEP. Lifestyle management, including weight loss, may be of great importance in the improvement of nocturia.
Collapse
Affiliation(s)
- Kaikai Lv
- Department of Urology, the Third Medical Centre, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China,Medical School of Chinese People's Liberation Army (PLA), Beijing, China
| | - Yangyang Wu
- Department of Urology, the Third Medical Centre, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China,Medical School of Chinese People's Liberation Army (PLA), Beijing, China
| | - Shuai Huang
- Department of Postgraduate, Hebei North University, Zhangjiakou, Hebei, China
| | - Zhenjun Luo
- Affiliated Hospital of Weifang Medical University, School of Clinical Medicine, Weifang Medical University, Weifang, China
| | - Wenhui Lai
- Department of Postgraduate, Hebei North University, Zhangjiakou, Hebei, China
| | - Qingyang Meng
- Department of Urology, the Third Medical Centre, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
| | - Xinze Xia
- Department of Urology, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Chao Lv
- Medical School of Chinese People's Liberation Army (PLA), Beijing, China
| | - Xiaowei Hao
- Department of Urology, the Third Medical Centre, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China,Medical School of Chinese People's Liberation Army (PLA), Beijing, China
| | - Tao Song
- Department of Urology, the Third Medical Centre, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China,Medical School of Chinese People's Liberation Army (PLA), Beijing, China,Correspondence: Qing Yuan Tao Song
| | - Qing Yuan
- Department of Urology, the Third Medical Centre, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China,Medical School of Chinese People's Liberation Army (PLA), Beijing, China,Correspondence: Qing Yuan Tao Song
| |
Collapse
|
6
|
Aucar N, Fagalde I, Zanella A, Capalbo O, Aroca-Martinez G, Favre G, Musso CG. Nocturia: its characteristics, diagnostic algorithm and treatment. Int Urol Nephrol 2023; 55:107-114. [PMID: 35945304 DOI: 10.1007/s11255-022-03317-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 07/25/2022] [Indexed: 01/05/2023]
Abstract
Nocturia is the complaint that an individual has to wake up at night one or more times to urinate. It is a frequent condition among older adults and entails detrimental effects with regard to sleeping, sexual activity, comfort, depression, mental function and vitality. It is clinically important to distinguish it from global polyuria, defined as a urinary rate ≥ 125 ml/h (3000 ml/day), as well as from nocturnal polyuria, which is an abnormally large volume of urine during sleep associated with a decreased daytime urine production. A Frequency Volume Chart (FVC), overnight water deprivation test with renal concentrating capacity test, and the nocturnal bladder capacity index are some of the methods that help establish the underlying pathology of this condition and hence define an adequate treatment plan.
Collapse
Affiliation(s)
- Nahir Aucar
- Physiology Department, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Ines Fagalde
- Physiology Department, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Akemi Zanella
- Physiology Department, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Olivia Capalbo
- Physiology Department, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Gustavo Aroca-Martinez
- Universidad del Norte, Barranquilla, Colombia.,Facultad de Ciencias de la Salud, Universidad Simón Bolivar, Barranquilla, Colombia
| | - Gabriel Favre
- Urology Division, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Carlos G Musso
- Physiology Department, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. .,Facultad de Ciencias de la Salud, Universidad Simón Bolivar, Barranquilla, Colombia.
| |
Collapse
|
7
|
Nguyen LN, Randhawa H, Nadeau G, Cox A, Hickling D, Campeau L, Li J, Welk B, Carlson K. Canadian Urological Association best practice report: Diagnosis and management of nocturia. Can Urol Assoc J 2022; 16:E336-E349. [PMID: 35819914 PMCID: PMC9328849 DOI: 10.5489/cuaj.7970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2024]
Affiliation(s)
- Laura N. Nguyen
- Division of Urology, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Harkanwal Randhawa
- Division of Urology, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Geneviève Nadeau
- Division of Urology, CIUSSS-Capitale Nationale Université Laval, Quebec, QC, Canada
| | - Ashley Cox
- Department of Urology, Dalhousie University, Halifax, NS, Canada
| | - Duane Hickling
- Division of Urology, Department of Surgery, The Ottawa Hospital, Ottawa, ON, Canada
| | - Lysanne Campeau
- Division of Urology, Department of Surgery, McGill University, Montreal, QC, Canada
| | - Juliana Li
- Division of Respirology, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Blayne Welk
- Division of Urology, Department of Surgery, Western University, London, ON, Canada
| | - Kevin Carlson
- Department of Surgery, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
8
|
De novo nocturia: A red flag for coronary heart disease patients. Prog Urol 2022; 32:756-762. [PMID: 35773176 DOI: 10.1016/j.purol.2022.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/21/2022] [Accepted: 05/29/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Nocturia is frequent among older patients and has been linked to cardiovascular diseases. The aim of this study was to assess the time relationship between the onset of nocturia and coronary heart disease (CHD). Specifically, this study investigated whether nocturia can be identified as a red flag de novo symptom in patients with CHD. METHODS This cross-sectional study consisted of patients with CHD-related cardiac complaints who were prospectively recruited from November 2019 till March 2020 at the cardiac catheterization laboratory of the Ghent University Hospital. An analysis was performed to determine the time relationship between nocturia and CHD and to describe the nocturia characteristics. RESULTS Forty-five patients with nocturia and established CHD were included. Of these patients, 74% (31/42) developed nocturia before their cardiac symptoms occurred, with a median time gap of 57 months (IQR 19-101). Furthermore, 64% (29/45) of them had clinically significant nocturia (≥2 nocturnal voids) and there was a significant correlation between age at which nocturia and cardiac symptoms occurred (r=0.89, p<0.001). CONCLUSION This is the first study that analysed the time relationship between onset of nocturia and onset of cardiac complaints in patients with CHD. In most of the patients, nocturia had started before they were diagnosed with CHD, meaning that nocturia might precede the development of cardiac symptoms, such as angina and shortness of breath. Keeping this in mind, de novo nocturia may or even should be considered as a red flag for CHD. LEVEL OF EVIDENCE: 4 (cross sectional study with prospectively recruitement) Source: https://www.ciap.health.nsw.gov.au/training/ebp-learning-modules/module1/grading-levels-of-evidence.html.
Collapse
|
9
|
Khosla L, Huang AJ, Kasarla N, Monaghan TF, Weiss JP, Kabarriti AE. Association between pregnancy and nocturia: A National Health and Nutrition Examination Survey analysis. Neurourol Urodyn 2022; 41:1505-1510. [PMID: 35731180 DOI: 10.1002/nau.24998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/25/2022] [Accepted: 06/14/2022] [Indexed: 11/11/2022]
Abstract
AIMS This study aimed to determine the impact of pregnancy and pregnancy-associated characteristics on nocturia. METHODS Using the National Health and Nutrition Examination Survey (NHANES) database from 2005/06 to 2017/18, we analyzed women who completed the "Reproductive Health" and "Kidney Conditions-Urology" questionnaires by sorting them into three groups: nulligravida, previously pregnant (nonpregnant with prior pregnancies), and currently pregnant. After excluding patients with pre-existing conditions impacting nocturia or with incomplete data, we weighed and matched the groups for age, race, BMI, and number of pregnancies. The relationships of nocturia to pregnancy in all groups and pregnancy-associated characteristics (gestational diabetes mellitus [GDM], history of multiple pregnancies, and trimesters of pregnancy) in currently pregnant women were assessed. RESULTS Of 8330 women that indicated pregnancy status, 1544 women (age range: 20-44 years; 523 nulligravida, 498 previously pregnant, 523 currently pregnant women) were included in analysis. Currently, pregnant women had a higher prevalence of nocturia than previously pregnant and nulligravida women (56.4% vs. 22.5% vs. 16.1%, p < 0.001) and had the highest odds of nocturia (OR: 6.82, p < 0.001). GDM or history of multiple pregnancies showed no associations in currently pregnant women. Increasing trimesters were associated with nocturia, with the third trimester showing the highest odds (OR: 10.35, p < 0.001) and a greater average of nighttime voids than the first and second trimesters (2.40 ± 1.42 vs. 1.56 ± 1.31 and 1.88 ± 1.32, p < 0.001). CONCLUSIONS The association noted between pregnancy and nocturia, which strengthened with increasing trimesters, demonstrates that nocturia can significantly impact quality of life and therefore must be addressed during pregnancy.
Collapse
Affiliation(s)
- Lakshay Khosla
- Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, New York, USA
| | - Aaron J Huang
- Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, New York, USA
| | - Nikhil Kasarla
- Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, New York, USA
| | - Thomas F Monaghan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jeffrey P Weiss
- Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, New York, USA
| | - Abdo E Kabarriti
- Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, New York, USA
| |
Collapse
|
10
|
Ikeda Y, Zabbarova I, de Rijk M, Kanai A, Wolf-Johnston A, Weiss JP, Jackson E, Birder L. Effects of vasopressin receptor agonists on detrusor smooth muscle tone in young and aged bladders: Implications for nocturia treatment. CONTINENCE (AMSTERDAM, NETHERLANDS) 2022; 2:100032. [PMID: 35789681 PMCID: PMC9250757 DOI: 10.1016/j.cont.2022.100032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE The main goal of this study was to determine the effects of arginine vasopressin (AVP) and desmopressin on bladder contractility and to examine whether the effects of these vasopressin receptor (VR) agonists differ in young versus aged animals. These aims were addressed using urinary bladders from young (3 months) and aged (24 month) female Fischer 344 rats that were isolated and dissected into strips for isometric tension recordings. Bladder strips were exposed to AVP and desmopressin through the perfusate, and tension changes recorded. RESULTS In young rat bladders, AVP, an agonist at both vasopressin-1 receptors (V1Rs) and vasopressin-2 receptor (V2Rs), concentration-dependently caused contraction of bladder strips with a sensitivity that was greater in young versus aged bladder strips. Removal of the mucosa did not alter the sensitivity of young bladder strips to AVP yet enhanced the AVP sensitivity of aged bladder strips. The differential sensitivity to AVP between young denuded and aged denuded bladder strips was similar. In contrast to AVP, desmopressin (V2R selective agonist) relaxed bladder strips. This response was reduced by removal of the mucosa in young, but not aged, bladder strips. CONCLUSION These findings support a direct role for VRs in regulating detrusor tone with V1Rs causing contraction and V2Rs relaxation. In aged bladders, the contractile response to V1R activation is attenuated due to release of a mucosal factor that attenuates V1R-induced contractions. Also in aged bladders, the relaxation response to V2R activation is attenuated by lack of release of a mucosal factor that contributes to V2R-induced relaxation. Thus age-associated changes in the bladder mucosa impair the effects of VRs on bladder tone. Because the V2R signaling system is impaired in the older bladder, administering an exogenous V2R agonist (e.g., desmopressin) could counteract this defect. Thus, desmopressin could potentially increase nighttime bladder capacity through detrusor relaxation in concert with decreased urine production, reducing nocturnal voiding frequency.
Collapse
Affiliation(s)
- Youko Ikeda
- University of Pittsburgh, School of Medicine, Renal-Electrolyte division, United States of America
- University of Pittsburgh, School of Medicine, Department of Pharmacology and Chemical Biology, United States of America
| | - Irina Zabbarova
- University of Pittsburgh, School of Medicine, Renal-Electrolyte division, United States of America
| | - Mathijs de Rijk
- Maastricht University, Faculty of Health, Medicine, and Life Sciences, School for Mental Health and Neurosciences, Department of Urology, the Netherlands
| | - Anthony Kanai
- University of Pittsburgh, School of Medicine, Renal-Electrolyte division, United States of America
- University of Pittsburgh, School of Medicine, Department of Pharmacology and Chemical Biology, United States of America
| | - Amanda Wolf-Johnston
- University of Pittsburgh, School of Medicine, Renal-Electrolyte division, United States of America
| | - Jeffrey P. Weiss
- SUNY Downstate Health Sciences University, Department of Urology, United States of America
| | - Edwin Jackson
- University of Pittsburgh, School of Medicine, Department of Pharmacology and Chemical Biology, United States of America
| | - Lori Birder
- University of Pittsburgh, School of Medicine, Renal-Electrolyte division, United States of America
- University of Pittsburgh, School of Medicine, Department of Pharmacology and Chemical Biology, United States of America
| |
Collapse
|
11
|
Azuero J, Santander J, Trujillo CG, Caicedo JI, Zuluaga L, Becerra AM, Daza F, Rondón M, Plata M. Potential associations of adult nocturia. Results from a national prevalence study. Neurourol Urodyn 2021; 40:819-828. [PMID: 33550620 DOI: 10.1002/nau.24624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/03/2021] [Accepted: 01/04/2021] [Indexed: 12/21/2022]
Abstract
AIM To determine the prevalence of nocturia and associated risk factors in the Colombian population aged ≥18 years old. METHODS This is a cross-sectional population-based study conducted in 1060 participants in Colombia. Nocturia was assessed with the Spanish version of the ICIQ-OAB, using the ICS terminology. Descriptive statistics were used to evaluate nocturia prevalence. Logistic regression analysis was carried out to determine the association of nocturia with predefined variables. RESULTS The prevalence of nocturia was 55.9% and it was more common in women than men (53.96% vs. 46.04%; p = .004). At least three episodes of nocturia were observed in 20.37% of the participants who had a severe alteration in their quality of life (p < .01). The bivariate model showed an association between nocturia and obesity (odds ratio [OR], 1.69; 90% confidence interval [CI]: 1.22-2.34), diabetes mellitus (OR, 2.99; 90% CI: 1.86-4.83), high blood pressure (OR, 2.04; 90% CI: 1.52-2.72), cardiovascular disease (OR, 1.75; 90% CI: 1.08 - 2.83), depression (OR, 1.89; 90% CI: 1.23-2.89), obstructive sleep apnea (OR, 1.70; 90% CI: 1.17 - 2.46), and childhood enuresis (OR, 1.45; 90% CI: 1.04-2.02). The multivariate model showed an association with obesity (OR, 2.0; 95% CI: 1.14 - 3.51) in women, as well as age ≥ 65 years (OR, 3.18; 95% CI: 1.26 - 8.02) and erectile dysfunction (OR, 3.44; 95% CI: 1.21 - 9.72) in men. Childhood enuresis was significantly associated with nocturia in both genders (OR, 1.61; 95% CI: 1.09 - 2.40 in women and OR, 1.66; 95% CI: 1.09-2.52 in men). CONCLUSION There is a significant prevalence of nocturia in our population and a clear association with impaired quality of life. We consider important to inquire about history of childhood enuresis to define the risk of presenting nocturia in adulthood. Nocturia was associated with multiple comorbidities. Obesity and erectile dysfunction play an important role as modifiable risk factor.
Collapse
Affiliation(s)
- Julian Azuero
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Universidad de los Andes School of Medicine, Bogotá, Colombia
| | - Jessica Santander
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Universidad de los Andes School of Medicine, Bogotá, Colombia
| | - Carlos Gustavo Trujillo
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Universidad de los Andes School of Medicine, Bogotá, Colombia
| | - Juan Ignacio Caicedo
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Universidad de los Andes School of Medicine, Bogotá, Colombia
| | - Laura Zuluaga
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Universidad de los Andes School of Medicine, Bogotá, Colombia
| | - Ana María Becerra
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Universidad de los Andes School of Medicine, Bogotá, Colombia
| | - Fabián Daza
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Universidad de los Andes School of Medicine, Bogotá, Colombia
| | - Martin Rondón
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Mauricio Plata
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Universidad de los Andes School of Medicine, Bogotá, Colombia
| |
Collapse
|
12
|
Przydacz M, Chlosta M, Dudek P, Cudnoch-Jedrzejewska A, Zgliczynski W, Dobruch J, Antoniewicz A, Chlosta P. Desmopressin treatment for nocturia caused by nocturnal polyuria: practical guidelines. Cent European J Urol 2020; 73:498-505. [PMID: 33552576 PMCID: PMC7848835 DOI: 10.5173/ceju.2020.0283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 10/06/2020] [Accepted: 10/10/2020] [Indexed: 12/14/2022] Open
Abstract
Introduction Desmopressin is an effective and safe therapy for nocturia caused by nocturnal polyuria. However, many physicians are unsure about the proper diagnosis of nocturnal polyuria and the identification of patients who may benefit from desmopressin treatment. Therefore, to support urologists in their routine clinical practice, the aim of this study was to provide a comprehensive paradigm for diagnosing nocturnal polyuria with recommendations for the use of desmopressin. Material and methods A multidisciplinary group of experts reviewed the available literature. Findings were compiled into a practice-based approach for workup and treatment. Results We designed the nocturia diagnostic pathway to confirm nocturnal polyuria, identify possible causes of nocturnal polyuria, and classify patients with indications and contraindications for desmopressin therapy. A bladder diary remains a basic diagnostic tool. Underlying conditions that may lead to nocturnal polyuria include mainly cardiac insufficiency, arterial hypertension, chronic kidney failure, obstructive sleep apnea, peripheral edema, and excessive fluid intake at night. Treatment for nocturia caused by nocturnal polyuria is based on conservative management and pharmacotherapy, but pharmacological treatment should not precede a prior attempt at conservative treatment. Before administration of desmopressin, patients should be assessed for serum sodium concentration and carefully educated about the symptoms of hyponatremia. Older individuals or persons with risk factors for the development of hyponatremia should be checked regularly for hyponatremia during desmopressin therapy. Conclusions People with nocturia due to nocturnal polyuria should be evaluated carefully before initiating desmopressin treatment. Patients treated with desmopressin should be followed for both clinical efficacy and treatment-related adverse effects.
Collapse
Affiliation(s)
- Mikolaj Przydacz
- Department of Urology, Jagiellonian University Medical College, Cracow, Poland
| | - Marcin Chlosta
- Department of Urology, Jagiellonian University Medical College, Cracow, Poland
| | - Przemyslaw Dudek
- Department of Urology, Jagiellonian University Medical College, Cracow, Poland
| | - Agnieszka Cudnoch-Jedrzejewska
- Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
| | - Wojciech Zgliczynski
- Department of Endocrinology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Jakub Dobruch
- Department of Urology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Artur Antoniewicz
- Department of Urology, Multidisciplinary Hospital Warsaw-Międzylesie, Warsaw, Poland
| | - Piotr Chlosta
- Department of Urology, Jagiellonian University Medical College, Cracow, Poland
| |
Collapse
|
13
|
Baines G, Da Silva AS, Cardozo L, Bach F, Parsons M, Robinson D, Toozs-Hobson P. Defining nocturnal polyuria in women. Neurourol Urodyn 2020; 40:265-271. [PMID: 33085813 DOI: 10.1002/nau.24546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/01/2020] [Accepted: 10/06/2020] [Indexed: 11/11/2022]
Abstract
AIMS Nocturnal polyuria (NP) is defined by the International Continence Society (ICS) as "excessive production of urine during the main sleep period" and is one of the main causes of nocturia. The ICS recognized that "excessive" is not clearly defined and that this needs to be highlighted in both clinical and research settings. The aim of this study was to identify different definitions of NP and apply them to a population of women attending the Urogynaecology clinic. METHODS This was a retrospective study of complete bladder diaries collected from women attending a tertiary Urogynaecology Unit. Six different definitions were identified and were divided into "absolute," "relative," and "functional definitions." Prevalence data were calculated and values generated for sensitivity, specificity, positive and negative predictive values when related to women voiding ≥ 2 times per night. RESULTS Complete bladder diaries were obtained from 1398 women, over 6 years, with a mean age of 57 years. Prevalence varied across the definitions from 21.5% (absolute definition) to 77% (relative definition). Sensitivity ranged from 43% (absolute) to 87% (relative). The definitions that showed the highest combined sensitivity and specificity were the functional definitions. CONCLUSION From this study it is clear that more work needs to be done to arrive at a consensus for defining NP to enable accurate diagnosis and development of treatment pathways. We propose that a relative definition may provide a more clinically relevant method of defining NP.
Collapse
Affiliation(s)
| | | | | | - Fiona Bach
- Birmingham Women's Hospital, Birmingham, England
| | | | | | | |
Collapse
|
14
|
Shieu M, Morgenstern H, Bragg-Gresham J, Gillespie BW, Shamim-Uzzaman QA, Tuot D, Saydah S, Rolka D, Burrows NR, Powe NR, Saran R. US Trends in Prevalence of Sleep Problems and Associations with Chronic Kidney Disease and Mortality. KIDNEY360 2020; 1:458-468. [PMID: 35368590 PMCID: PMC8809315 DOI: 10.34067/kid.0000862019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 04/24/2020] [Indexed: 06/14/2023]
Abstract
BACKGROUND To better understand the relation between sleep problems and CKD, we examined temporal trends in the prevalence of self-reported sleep problems in adults in the United States and their associations with CKD and all-cause mortality. METHODS Using data from 27,365 adult participants in five biannual National Health and Examination Surveys (2005-2006 through 2013-2014), we studied five self-reported sleep problems-trouble sleeping, sleep disorder, nocturia (urinating ≥2 times/night), inadequate sleep (<7 hours/night), and excessive sleep (>9 hours/night)-plus a composite index. We conducted three types of analysis: temporal trends in the prevalence of each sleep measure by CKD status, using model-based standardization; cross-sectional analysis of associations between four CKD measures and each sleep measure, using logistic regression; and survival analysis of the association between each sleep measure and mortality, using Cox regression. RESULTS The prevalence of trouble sleeping and sleep disorder increased over the five surveys by 4% and 3%, respectively, whereas the other sleep problems remained relatively stable. All sleep problems, except inadequate sleep, were more common during the study period among adults with CKD than without CKD (40% versus 21% for nocturia; 5% versus 2% for excessive sleep; 30% versus 25% for trouble sleeping; 12% versus 8% for sleep disorder). Both eGFR <30 ml/min per 1.73 m2 and albuminuria were positively associated with nocturia and excessive sleep. Excessive sleep and nocturia were also associated with higher mortality (adjusted hazard ratio for >9 versus 7-9 hours/night=1.7; 95% CI, 1.3 to 2.1; and for nocturia=1.2; 95% CI, 1.1 to 1.4). CONCLUSIONS The high prevalence of sleep problems among persons with CKD and their associations with mortality suggest their potential importance to clinical practice. Future work could examine the health effects of identifying and treating sleep problems in patients with CKD.
Collapse
Affiliation(s)
- Monica Shieu
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
- Kidney Epidemiology and Cost Center, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Hal Morgenstern
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
- Department of Environmental Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan
- Department of Urology, Medical School, University of Michigan, Ann Arbor, Michigan
| | - Jennifer Bragg-Gresham
- Kidney Epidemiology and Cost Center, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Brenda W. Gillespie
- Kidney Epidemiology and Cost Center, School of Public Health, University of Michigan, Ann Arbor, Michigan
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Q. Afifa Shamim-Uzzaman
- Division of Neurology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Delphine Tuot
- Departments of Medicine, University of California San Francisco, San Francisco, California
| | - Sharon Saydah
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Deborah Rolka
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Neil R. Powe
- Departments of Medicine, University of California San Francisco, San Francisco, California
| | - Rajiv Saran
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
- Kidney Epidemiology and Cost Center, School of Public Health, University of Michigan, Ann Arbor, Michigan
- Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | | |
Collapse
|
15
|
[Diagnostic and therapeutic approach to nocturia in Primary Care]. Semergen 2020; 46:487-496. [PMID: 32467014 DOI: 10.1016/j.semerg.2020.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 03/06/2020] [Indexed: 11/21/2022]
Abstract
Nocturia is the interruption of the main sleep, one or more times, due to the need for urination. It is associated with a decrease in the quality of life and an increase in mortality. It is a complex and multifactorial symptom in which two pathophysiological mechanisms are mainly involved. These occur alone or in combination as nocturnal polyuria or decreased bladder capacity. Nocturnal polyuria is the most frequent. The preparation of a bladder diary is the key to diagnosis. Treatment usually combines lifestyle changes and drug therapy. Desmopressin has proven to be an effective and well-tolerated treatment in patients with nocturnal polyuria. The risk of hyponatraemia should be controlled in patients treated with desmopressin.
Collapse
|
16
|
Yoshikawa M, Torimoto K, Hirayama A, Kiba K, Yamamoto Y, Akashi Y, Shimizu N, Tanaka N, Uemura H, Fujimoto K. Daily salt intake is associated with leg edema and nocturnal urinary volume in elderly men. Neurourol Urodyn 2020; 39:1550-1556. [PMID: 32460398 DOI: 10.1002/nau.24401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 05/09/2020] [Indexed: 12/13/2022]
Abstract
AIMS There is accumulating evidence that excessive salt intake contributes to nocturnal polyuria. We aimed to investigate the relationship between salt intake, leg edema, and nocturnal urine volume (NUV) to assess the etiology of nocturnal polyuria. METHODS A total of 56 men aged ≥60 years who were hospitalized for benign prostatic hyperplasia or with suspected prostatic cancer were enrolled. Urine frequency-volume charts of the patients were maintained, and they underwent bioelectrical impedance analysis twice daily (at 5:00 pm and 6:00 am) and examination of blood (brain natriuretic peptide levels) and urine (sodium and creatinine levels and osmotic pressure) samples once daily (at 6:00 am). Free-water clearance, solute clearance, and sodium clearance at night were measured, and daily salt intake was estimated. RESULTS The data of 52 patients were analyzed. Daily salt intake positively correlated with leg edema at 5:00 pm, differences in leg extracellular fluid levels between 5:00 pm and 6:00 am, and NUV, but not with diurnal urine volume. Partial correlation coefficients showed that salt intake was a factor of the correlation between NUV and change in extracellular volume in the legs between 5:00 pm and 6:00 am. A multivariate logistic model showed that sleep duration and sodium clearance were independent predictive factors for nocturnal polyuria. CONCLUSIONS Sodium intake correlates with diurnal leg edema and NUV in elderly men. These results provide evidence supporting sodium restriction as an effective treatment for nocturnal polyuria.
Collapse
Affiliation(s)
- Motokiyo Yoshikawa
- Department of Urology, Yamato Takada Municipal Hospital, Yamatotakada, Nara, Japan
| | - Kazumasa Torimoto
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Akihide Hirayama
- Department of Urology, Kindai University Nara Hospital, Ikoma, Nara, Japan
| | - Keisuke Kiba
- Department of Urology, Kindai University Nara Hospital, Ikoma, Nara, Japan
| | - Yutaka Yamamoto
- Department of Urology, Kindai University Nara Hospital, Ikoma, Nara, Japan
| | - Yasunori Akashi
- Department of Urology, Kindai University Nara Hospital, Ikoma, Nara, Japan
| | - Nobutaka Shimizu
- Department of Urology, Kindai University Faculty of Medicine, Osakasayama, Osaka, Japan
| | - Nobumichi Tanaka
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Hirotsugu Uemura
- Department of Urology, Kindai University Faculty of Medicine, Osakasayama, Osaka, Japan
| | - Kiyohide Fujimoto
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| |
Collapse
|
17
|
Lee DS, Kim SW, Sohn DW. Association between Nocturnal Frequency and Erectile Function in Eugonadal Men with Benign Prostatic Obstruction: A Cross Sectional Study. World J Mens Health 2020; 39:338-345. [PMID: 32202080 PMCID: PMC7994652 DOI: 10.5534/wjmh.190146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 12/29/2019] [Indexed: 01/04/2023] Open
Abstract
Purpose We aimed to evaluate the association between nocturnal frequency and erectile dysfunction in patients with benign prostatic obstruction. Materials and Methods To evaluate the association, we simultaneous evaluated urodynamic study, prostate ultrasound, nocturnal tumescence test (nocturnal penile tumescence) for sleep-related erection (SRE) and two questionnaires, international prostate symptom score (IPSS) and 5-item version of the international index of erectile function (IIEF-5). Patients with hypogonadism or nocturnal polyuria were excluded. Results Forty-six patients were registered over 4 years. The mean age, prostate size, IPSS score, and IIEF-5 score were 67.65±5.51 years, 65.10±22.12 mL, 24.67±7.89, and 9.50±7.01, respectively. Among the IPSS subscores, nocturia was most significantly related to the total IIEF-5 score (p<0.001). More severe nocturia was associated with less frequent SRE (p=0.003) and shorter total duration of SRE (p=0.002), which in turn elucidated that nocturia was significantly related to the total amount of rigidity signals (rigidity activity unit, RAU) or tumescence signals (tumescence activity unit, TAU). Among objective urodynamic parameters, bladder compliance also correlated to RAU and TAU. Individual subjective erectile function (IIEF-5) was significantly related to both RAU and TAU. Conclusions Sleep fragmentation due to benign prostate obstruction related nocturnal frequency caused by reduced bladder compliance could decrease the frequency and duration of SRE, which decreases the total amount of SRE and reflects the patient's relevant erectile function.
Collapse
Affiliation(s)
- Dong Sup Lee
- Department of Urology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Sae Woong Kim
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Wan Sohn
- Department of Urology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
| |
Collapse
|
18
|
Choi EPH, Wan EYF, Kwok JYY, Chin WY, Lam CLK. The mediating role of sleep quality in the association between nocturia and health-related quality of life. Health Qual Life Outcomes 2019; 17:181. [PMID: 31829192 PMCID: PMC6907224 DOI: 10.1186/s12955-019-1251-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 11/26/2019] [Indexed: 12/15/2022] Open
Abstract
Background Even though the negative impacts of nocturia on sleep quality and health-related quality of life (HRQOL) have been documented in previous research, their interrelationship has been poorly studied. This study aimed to explore whether nocturia would affect sleep quality, which in turn affects HRQOL. Methods Participants aged 40 and above were randomly recruited from a Hong Kong public primary care clinic. Participants were asked to report the average number of nocturia (waking up at night to void) pisodes per night over a 1-month period. The Pittsburgh Sleep Quality Index (PSQI) and the 12-Item Short Form Health Survey version 2 (SF-12 v2) were administered. The mediation analysis was tested using multistage regression approach and bootstrap method. Results Of the 500 subjects who completed the survey, 31.2% reported symptomatic nocturia (having ≥2 nocturia episodes per night), and 60.4% experienced poor sleep quality (a PSQI global score > 5). Respondents with symptomatic nocturia had a poorer HRQOL in the domains of physical functioning (PF), role physical (RP) and social functioning (SF), general health (GH), vitality (VT) and physical component summary (PCS) of the SF-12 v2 than those without. Compared with the respondents without poor sleep quality, those with poor sleep quality had poorer HRQOL across all domains and summaries of the SF-12 v2. Mediation analysis found that sleep quality fully mediated the association between nocturia and the PF, RP and SF domains of the SF-12 v2, respectively, and partially mediated the association between nocturia and the GH, VT and PCS domains of the SF-12 v2, respectively. Conclusions We found that sleep quality mediated the association between nocturia and HRQOL. To enhance the HRQOL of patients with nocturia, clinicians should not only focus on nocturia symptoms, but also on their sleep quality.
Collapse
Affiliation(s)
- Edmond Pui Hang Choi
- School of Nursing, University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong.
| | - Eric Yuk Fai Wan
- Department of Family Medicine and Primary Care, University of Hong Kong, Pokfulam, Hong Kong.,Department of Pharmacology and Pharmacy, University of Hong Kong, Pokfulam, Hong Kong
| | - Jojo Yan Yan Kwok
- School of Nursing, University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Weng Yee Chin
- Department of Family Medicine and Primary Care, University of Hong Kong, Pokfulam, Hong Kong
| | - Cindy Lo Kuen Lam
- Department of Family Medicine and Primary Care, University of Hong Kong, Pokfulam, Hong Kong
| |
Collapse
|
19
|
Tabara Y, Matsumoto T, Murase K, Setoh K, Kawaguchi T, Nagashima S, Funada S, Kosugi S, Hirai T, Nakayama T, Wakamura T, Chin K, Matsuda F. Lifestyle habits associated with nocturnal urination frequency: The Nagahama study. Neurourol Urodyn 2019; 38:2359-2367. [DOI: 10.1002/nau.24156] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 08/18/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Yasuharu Tabara
- Center for Genomic MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Takeshi Matsumoto
- Department of Respiratory MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Kimihiko Murase
- Department of Respiratory Care and Sleep Control MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Kazuya Setoh
- Center for Genomic MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Takahisa Kawaguchi
- Center for Genomic MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Shunsuke Nagashima
- Department of Human Health ScienceKyoto University Graduate School of Medicine Kyoto Japan
| | - Satoshi Funada
- Department of UrologyKyoto University Hospital Kyoto Japan
| | - Shinji Kosugi
- Department of Medical Ethics and Medical GeneticsKyoto University School of Public Health Kyoto Japan
| | - Toyohiro Hirai
- Department of Respiratory MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Takeo Nakayama
- Department of Health InformaticsKyoto University School of Public Health Kyoto Japan
| | - Tomoko Wakamura
- Department of Human Health ScienceKyoto University Graduate School of Medicine Kyoto Japan
| | - Kazuo Chin
- Department of Respiratory Care and Sleep Control MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Fumihiko Matsuda
- Center for Genomic MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | | |
Collapse
|
20
|
Tabara Y, Ikezoe T, Matsumoto T, Murase K, Setoh K, Funada S, Kawaguchi T, Nagashima S, Kosugi S, Hirai T, Nakayama T, Wakamura T, Chin K, Ichihashi N, Tsuboyama T, Matsuda F. Association of weak hip abduction strength with nocturia in older women: The Nagahama study. Geriatr Gerontol Int 2019; 19:1010-1016. [DOI: 10.1111/ggi.13761] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/22/2019] [Accepted: 07/31/2019] [Indexed: 01/13/2023]
Affiliation(s)
- Yasuharu Tabara
- Center for Genomic MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Tome Ikezoe
- Department of Human Health SciencesKyoto University Graduate School of Medicine Kyoto Japan
| | - Takeshi Matsumoto
- Department of Respiratory MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Kimihiko Murase
- Department of Respiratory Care and Sleep Control MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Kazuya Setoh
- Center for Genomic MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Satoshi Funada
- Department of UrologyKyoto University Hospital Kyoto Japan
| | - Takahisa Kawaguchi
- Center for Genomic MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Shunsuke Nagashima
- Department of Human Health SciencesKyoto University Graduate School of Medicine Kyoto Japan
| | - Shinji Kosugi
- Department of Medical Ethics and Medical GeneticsKyoto University School of Public Health Kyoto Japan
| | - Toyohiro Hirai
- Department of Respiratory MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Takeo Nakayama
- Department of Health InformaticsKyoto University School of Public Health Kyoto Japan
| | - Tomoko Wakamura
- Department of Human Health SciencesKyoto University Graduate School of Medicine Kyoto Japan
| | - Kazuo Chin
- Department of Respiratory Care and Sleep Control MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Noriaki Ichihashi
- Department of Human Health SciencesKyoto University Graduate School of Medicine Kyoto Japan
| | - Tadao Tsuboyama
- Department of Human Health SciencesKyoto University Graduate School of Medicine Kyoto Japan
- School of Health SciencesBukkyo University Kyoto Japan
| | - Fumihiko Matsuda
- Center for Genomic MedicineKyoto University Graduate School of Medicine Kyoto Japan
| |
Collapse
|
21
|
Frequent nocturnal urination in older men is associated with arterial stiffness: The Nagahama study. Hypertens Res 2019; 42:1996-2001. [DOI: 10.1038/s41440-019-0309-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 06/19/2019] [Accepted: 07/12/2019] [Indexed: 12/23/2022]
|
22
|
Lombardo R, Tubaro A, Burkhard F. Nocturia: The Complex Role of the Heart, Kidneys, and Bladder. Eur Urol Focus 2019; 6:534-536. [PMID: 31395515 DOI: 10.1016/j.euf.2019.07.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 07/12/2019] [Accepted: 07/25/2019] [Indexed: 12/16/2022]
Abstract
We review the role of the heart, kidneys, and bladder in the pathophysiology of nocturia and nocturnal polyuria. Lower urinary tract symptoms such as nocturia have often been associated with lower urinary tract dysfunction. It is known that the bladder contributes to nocturia in the case of low functional capacity, urgency, and detrusor overactivity. Heart diseases, especially arterial hypertension and congestive heart failure, are closely related to nocturnal polyuria. The main mechanisms include renal hyperfiltration and elevated atrial natriuretic peptide. A number of drugs frequently used in cardiovascular disorders are implicated in nocturia; diuretics, calcium channel blockers, and β-blockers induce nocturnal polyuria and thus nocturia, whereas alpha-blockers improve nocturia. Among the different forms of hypertension, nondipping arterial hypertension has been associated with a higher risk of nocturnal polyuria. Besides the role of the kidneys in nocturia linked to arterial hypertension, chronic kidney disease is an independent predictor of nocturia through an osmotic diuresis mechanism. Some evidence suggests a close relationship between the heart (nondipping arterial hypertension), kidneys (chronic kidney disease), and nocturia/nocturnal polyuria. These complex interactions between the heart, kidneys, and bladder warrant a multidisciplinary approach in patients with nocturia. PATIENT SUMMARY: We review the different mechanisms that lead to nocturia and nocturnal polyuria. The complex interactions between the heart, the kidneys, and the bladder warrant a multidisciplinary approach in patients with nocturia. Careful investigation of the cause of nocturia can improve its management.
Collapse
Affiliation(s)
| | - Andrea Tubaro
- Ospedale Sant' Andrea, Sapienza University of Rome, Rome, Italy
| | - Fiona Burkhard
- Department of Urology, Inselspital University Hospital Bern, Bern, Switzerland
| |
Collapse
|
23
|
Li ESW, Flores VX, Weiss JP. Current guidelines and treatment paradigms for nocturnal polyuria: A "NEW" disease state for US physicians, patients and payers. Int J Clin Pract 2019; 73:e13337. [PMID: 30810265 DOI: 10.1111/ijcp.13337] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 02/05/2019] [Accepted: 02/24/2019] [Indexed: 01/08/2023] Open
Abstract
Nocturia is one of the most bothersome symptoms encountered in urology, and its prevalence rises with age. Causes include both urological and non-urological aetiologies, often in combination. The effects of nocturia on a patient's quality of life can be detrimental. The initial approach to managing this condition includes appropriately classifying nocturia based on the results of a 24-hour bladder diary. Broadly, the categories under which nocturia can be classified include: low nocturnal or global bladder capacity, nocturnal polyuria, global polyuria and mixed.Based on the type of nocturia and possible underlying causes, clinicians can appropriately discuss with patients the treatment plans that may include a combination of behavioural, pharmacologic, and invasive therapy. The available literature on the management of nocturia was reviewed. Findings were incorporated into a practice-based approach for its workup and treatment.
Collapse
Affiliation(s)
- Eric S W Li
- Department of Urology, State University of New York Downstate Medical Center, Brooklyn, New York
| | - Viktor X Flores
- Department of Urology, State University of New York Downstate Medical Center, Brooklyn, New York
| | - Jeffrey P Weiss
- Department of Urology, State University of New York Downstate Medical Center, Brooklyn, New York
| |
Collapse
|
24
|
The Association Between Obesity and the Nocturia in the U.S. Population. Int Neurourol J 2019; 23:169-176. [PMID: 31260617 PMCID: PMC6606941 DOI: 10.5213/inj.1938062.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 05/13/2018] [Indexed: 12/04/2022] Open
Abstract
Purpose We aimed to investigate the association of obesity with nocturia using a nationally representative sample of adults from the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2012. Methods A total of 14,135 participants were included in this study. We performed a multivariate logistic regression analysis to find the odds ratio (OR) of obesity for nocturia. Furthermore, the OR of BMI for nocturia was analyzed using restricted cubic splines (RCS) with five knots. We conducted subgroup analysis according to age, sex, hypertension, and diabetes mellitus (DM) and further analysis with 1:1 matching data with propensity score. Results The participants who had body mass index (BMI) above 30 kg/m2 had a significantly higher OR for nocturia (OR, 1.39; 95% CI, 1.28–1.50) than those without obesity. RCS showed a dose-dependent relationship between BMI and OR for nocturia. Subgroup analysis by age, sex, hypertension, and DM showed similar results. Further analysis with 1:1 matching data showed a significant association of obesity with the prevalence of nocturia (OR, 1.25; 95% CI, 1.10–1.41). Conclusions This study reported that obesity was significant association with the prevalence of nocturia with dose-dependent manner, regardless of age, sex, hypertension, and DM after taking major confounding factors into account.
Collapse
|
25
|
Choi YS, Kim JC, Kim YH, Choi JB, Park WH, Lee DH. Classification of nocturia by analyzing frequency volume chart and relations with international prostate symptom score in male patients with lower urinary tract symptoms in Korea. Investig Clin Urol 2019; 60:267-274. [PMID: 31294136 PMCID: PMC6607079 DOI: 10.4111/icu.2019.60.4.267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 04/25/2019] [Indexed: 12/05/2022] Open
Abstract
Purpose To evaluate the categories of nocturia and relationships with the international prostate symptom score (IPSS) in Korean men with lower urinary tract symptoms (LUTS) accompanying nocturia. Materials and Methods Five hundred twenty-one male patients from five different hospitals, aged ≥18 years, were included. The 3-day frequency volume chart was used to identify nocturia. We also used the IPSS and The International Consultation on Incontinence Modular Questionnaire-Nocturia (ICIQ-N) module to verify the correlation between nocturia and quality of life. Results The distribution of nocturia events varied from 1 to 11, and 2 nocturia events were most prevalent (48.4%). Across the various numbers of nocturia events, the mean age, first sleep period, functional bladder capacity (FBC), nocturnal polyuria index (NPI), nocturia index (NI), predicted number of nightly voids, and nocturnal bladder capacity index (NBCI) were statistically different. Patients with pure nocturnal polyuria showed different night lengths, nocturnal urine volume, FBC, NPI, NI, and predicted number of nightly voids than those without nocturnal polyuria. Patients with severely reduced NBCI were prominent in the IPSS >20 group, and the degree of vexation increased with the number of nocturia events. The IPSS storage symptom score and ICIQ-N symptom score positively correlated with nocturia events. Conclusions In Korean male LUTS patients with nocturia, mixed-type nocturia was prominent, and patients with a high IPSS had a much poorer sleep quality than those with a low IPSS.
Collapse
Affiliation(s)
- Yong Sun Choi
- Department of Urology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Joon Chul Kim
- Department of Urology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Young Ho Kim
- Department of Urology, Soonchunhyang University Bucheon Hospital, College of Medicine, Soonchunhyang University, Bucheon, Korea
| | - Jong Bo Choi
- Department of Urology, Ajou University School of Medicine, Suwon, Korea
| | - Won Hee Park
- Department of Urology, Inha University Hospital, College of Medicine, Inha University, Incheon, Korea
| | - Dong Hwan Lee
- Department of Urology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| |
Collapse
|
26
|
Lee C, Kuo H. Male patients with a higher frequency of nocturnal urinary episodes are more likely to benefit from alpha‐blocker therapy for bothersome nocturia. Low Urin Tract Symptoms 2019; 11:O174-O179. [DOI: 10.1111/luts.12246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 09/20/2018] [Accepted: 10/26/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Cheng‐Ling Lee
- Department of UrologyBuddhist Tzu Chi General Hospital and Tzu Chi University Hualien Taiwan
| | - Hann‐Chorng Kuo
- Department of UrologyBuddhist Tzu Chi General Hospital and Tzu Chi University Hualien Taiwan
| |
Collapse
|
27
|
Yoo S, Lee Y, Park J, Cho SY, Cho MC, Jeong H, Son H. Voided volume < 150 mL on initial uroflowmetry in men with storage symptoms: Is it an unreliable test result or a sign of severe storage symptoms? PLoS One 2019; 14:e0207208. [PMID: 30615618 PMCID: PMC6322755 DOI: 10.1371/journal.pone.0207208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 10/26/2018] [Indexed: 11/18/2022] Open
Abstract
Purpose To assess the utility of voided volume on initial uroflowmetry in predicting symptom severity in men with storage symptoms. In addition, we assessed the probability that men would show a voided volume of ≥ 150 mL on uroflowmetry if the examination is repeated. Methods Between 2016 and 2017, 352 men with storage symptoms were enrolled in the study. The patients completed the frequency–volume chart and were divided into four groups based on the voided volume. A multivariate analysis was performed to determine the variables affecting voided volume. Results The VV was < 68.8 mL in 88 patients (25.0%), 68.9–150 in 89 (25.3%), 150–250 in 87 (24.7%), and ≥ 250 in 88 (25.0%) patients. Although the International Prostate Symptom Score did not differ among the groups, the storage subscore was significantly higher in patients with decreased voided volume (p = 0.010). The total number of voids was greater in patients with decreased voided volume (p < 0.001), as was the number of nocturnal voids (p = 0.007). The maximum voided volume (p < 0.001) and 24-h urine output (p = 0.003) decreased as voided volume decreased. The proportions of patients with a mean daytime urine output ≥ 150 mL were 30.1%, 43.0%, 64.7%, and 66.7% in each group, respectively (p < 0.001). Older age and decreased maximum voided volume significantly affected the voided volume on initial uroflowmetry. Conclusions A decreased voided volume on initial uroflowmetry may be a sign of severe storage symptoms in men. This finding is related to older age and decreased functional capacity. In these patients, it is better to perform a careful clinical assessment to diagnose and treat overactive bladder.
Collapse
Affiliation(s)
- Sangjun Yoo
- Department of Urology, Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Youkyung Lee
- Department of Urology, Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Juhyun Park
- Department of Urology, Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Sung Yong Cho
- Department of Urology, Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Min Chul Cho
- Department of Urology, Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Hyeon Jeong
- Department of Urology, Seoul National University Boramae Medical Center, Seoul, South Korea
- Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hwancheol Son
- Department of Urology, Seoul National University Boramae Medical Center, Seoul, South Korea
- Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
- * E-mail:
| |
Collapse
|
28
|
Yoo S, Park J, Cho SY, Cho MC, Jeong H, Son H. Usefulness of the frequency-volume chart over the International Prostate Symptom Score in patients with benign prostatic hyperplasia in view of global polyuria. PLoS One 2018; 13:e0197818. [PMID: 29995878 PMCID: PMC6040686 DOI: 10.1371/journal.pone.0197818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 05/09/2018] [Indexed: 11/19/2022] Open
Abstract
Purpose We aimed to determine the usefulness of the frequency-volume chart over the International Prostate Symptom Score in patients with benign prostatic hyperplasia. Furthermore, we investigated the clinical characteristics suggesting that patients could benefit from frequency-volume chart assessment in addition to International Prostate Symptom Score assessment. Methods A total of 193 patients with benign prostatic hyperplasia were analyzed. The relationship between the information obtained from the frequency-volume chart and the International Prostate Symptom Score was assessed. Because the urine output per kilogram per hour was not associated with any question in the International Prostate Symptom Score questionnaire, patients were divided into 2 groups according to the presence of global polyuria, defined as urine output >40 mL·kg-1·h-1. Multivariable analysis was performed to determine the predictors of global polyuria, and the results were externally validated using 397 patients with benign prostatic hyperplasia. Results Although the other information obtained from the frequency-volume chart correlated with the International Prostate Symptom Score, the urine output was not associated with the International Prostate Symptom Score. Based on these results, patients were dichotomized into the global polyuria group (n = 19, 9.8%) and the non-global polyuria group. Although the patient characteristics did not differ between the 2 groups, the number of voids was higher in patients with global polyuria. Multivariable analysis showed that diabetes mellitus (odds ratio: 3.497, p = 0.039) and increased number of voids (odds ratio: 1.320, p < 0.001) were significant predictors of global polyuria. On external validation, the area under curve for the model was 0.723. Conclusions Global polyuria cannot be suspected using the International Prostate Symptom Score, although it worsens the lower urinary tract symptoms of patients with benign prostatic hyperplasia. Assessment with the frequency-volume chart needs to be considered in diabetic patients with increased number of voids.
Collapse
Affiliation(s)
- Sangjun Yoo
- Department of Urology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Juhyun Park
- Department of Urology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Sung Yong Cho
- Department of Urology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Min Chul Cho
- Department of Urology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Hyeon Jeong
- Department of Urology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
- Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hwancheol Son
- Department of Urology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
- Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
- * E-mail:
| |
Collapse
|
29
|
Chow PM, Liu SP, Chuang YC, Lee KS, Yoo TK, Liao L, Wang JY, Liu M, Sumarsono B, Jong JJ. The prevalence and risk factors of nocturia in China, South Korea, and Taiwan: results from a cross-sectional, population-based study. World J Urol 2018; 36:1853-1862. [DOI: 10.1007/s00345-018-2329-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 05/08/2018] [Indexed: 10/16/2022] Open
|
30
|
Kira S, Mitsui T, Miyamoto T, Ihara T, Nakagomi H, Sawada N, Takeda M. Lack of Change in the Adaptation Ability of the Bladder for the Urine Production Rate in Aged Men with Nocturia. Urol Int 2018; 100:445-449. [DOI: 10.1159/000488002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 02/26/2018] [Indexed: 11/19/2022]
|
31
|
Musculoskeletal pain profile of obese individuals attending a multidisciplinary weight management service. Pain 2018; 158:1342-1353. [PMID: 28383311 DOI: 10.1097/j.pain.0000000000000918] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Obesity is associated with numerous chronic diseases, including musculoskeletal (MSK) pain, which affects on quality of life (QoL). There is, however, limited research providing a comprehensive MSK pain profile of an obese cohort. This retrospective study used a patient database at a national weight management service. After ethical approval, anonymized patient data were statistically analyzed to develop a pain profile, investigate relationships between pain, sleep, and function, and explore variables associated with having low back pain (LBP) and knee pain. Overall, 915 individuals attended the weight management service from January 2011 to September 2015 [male, 35% (n = 318; confidence interval [CI] = 32-38); female, 65% (n = 597; CI = 62-68); mean age 44.6]. Mean body mass index was 50.7 kg/m [class III obese (body mass index ≥40 kg/m), 92% (n = 835; CI = 91-94)]. Approximately 91% reported MSK pain: LBP, 69% (n = 539; CI = 65-72) [mean Numeric Rating Scale 7.4]; knee pain, 58% (n = 447; CI = 55-61) [mean Numeric Rating Scale 6.8]. Class III obese and multisite pain patients had lower QoL and physical activity levels, reduced sleep, and poorer physical function than less obese patients and those without pain (P < 0.05). Relationships were found between demographic, pain, self-report, psychological, and functional measures (P < 0.05). Patients who slept fewer hours and had poorer functional outcomes were more likely to have LBP; patients who were divorced, had lower QoL, and more frequent nocturia were more likely to have knee pain (P < 0.05). Multisite MSK pain is prevalent and severe in obese patients and is negatively associated with most self-report and functional outcomes. This high prevalence suggests that pain management strategies must be considered when treating obesity.
Collapse
|
32
|
Abstract
Purpose of Review To assess current pharmacological principles used for treatment of nocturia/nocturnal polyuria. Recent Findings The pathophysiology of nocturia is often multifactorial, but two main mechanisms have been identified, occurring alone or in combination: low functional bladder capacity and nocturnal polyuria. The multifactorial pathophysiology not only implies several possible targets for therapeutic intervention but also means that it is unlikely that one treatment modality including drugs will be successful in all patients. Drugs approved for the treatment of male LUTS and male and female OAB are known to be far more effective for treatment of the daytime symptoms than for nocturia. Summary Several pharmacological principles have been tested with varying success. The treatment of choice should depend upon the main underlying cause, thus aiming primarily to increase bladder capacity by counteracting detrusor overactivity and/or reducing nocturnal polyuria. Using current available agents, effective, personalized treatment should be designed taking into account gender, co-morbidities, and identified etiological factors. However, there is a medical need for new, approved drugs for treatments for patients with nocturia.
Collapse
Affiliation(s)
- Karl-Erik Andersson
- Lund University, Lund, Sweden. .,Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston Salem, NC, USA. .,Institute of Clinical Medicine, Department of Obstetrics and Gynecology, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, DK, Denmark.
| | - Philip Van Kerrebroeck
- Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands
| |
Collapse
|
33
|
Abstract
Nocturia is a widespread condition that can negatively impact quality of sleep and overall health. This condition is multifactorial in nature and is best approached through the analysis of frequency volume charts. Through these charts, clinicians may classify each individual case of nocturia into one of four distinct categories: global polyuria, nocturnal polyuria, reduced bladder capacity, and mixed. Treatments should then be tailored to each individual based upon the category of their nocturia. In some cases, appropriate therapy will consist of behavioral modification techniques or addressing underlying systemic diseases. In other cases, medical therapy may be necessary, but, to date, medications have shown limited efficacy at treating nocturia.
Collapse
Affiliation(s)
- Noam D. Fine
- Department of Urology, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Jeffrey P. Weiss
- Department of Urology, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Alan J. Wein
- Division of Urology, University of Pennsylvania, Philadelphia, Pennsylvania , USA
| |
Collapse
|
34
|
Accurate Estimation of Prostate Size in the Evaluation of Nocturia. CURRENT BLADDER DYSFUNCTION REPORTS 2017. [DOI: 10.1007/s11884-017-0420-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
35
|
Sung HH, Ko KJ, Suh YS, Kim JC, Choi JB, Song YS, Lee KS. Tailoring pharmacotherapy for male lower urinary tract symptoms: A prospective, multicenter, observational trial. Int J Clin Pract 2017; 71. [PMID: 28508459 DOI: 10.1111/ijcp.12947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 03/08/2017] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the pattern of tailoring and efficacy of several types of pharmacotherapy in male LUTS. METHODS Prospectively 404 male subjects were included who were over 40 years old, had at least 3 months symptom duration, and 12 or higher international prostate symptom score (IPSS). Subjects were treated with several types of pharmacotherapy for 6 months and were evaluated with IPSS/QoL at every follow-up. Subjects were subdivided into storage (44%), nocturia (18.5%), and voiding symptom (37.5%) groups according to the most bothersome symptom. RESULTS At 6 months, 188 subjects (46.5%) completed the study. The mean age was 64.2±8.5 years, and symptom duration was 30.6±32.6 months. PSA was 2.98±7.96 ng/mL, and prostate size was 32.8±14.2 cc. IPSS continually decreased from baseline (18.7) to last follow-up (10.8). Combination therapy increased from 33.0% to 52.7% at last follow-up (P=.006). However, there was no difference of IPSS changes between combination and monotherapy groups (P>.05). Only antimuscarinic prescription significantly increased from 15.4% to 28.2% (P=.004). Mean number of visits to the clinic was 3.6±1.3 and the number of treatment changes was 0.31±0.47. The nocturia (0.47±0.51) group changed treatment more than voiding group (0.21±0.41, P=.003). However, the voiding group (-9.4) had significantly more improvement than e storage (-6.4) and nocturia (-7.8) groups (P=.011). CONCLUSIONS Male LUTS continually improved over 6 months with customised treatment. Pharmacotherapy for male LUTS should be tailored by symptom type and alteration of symptoms during treatment.
Collapse
Affiliation(s)
- Hyun Hwan Sung
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kwang Jin Ko
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon Seok Suh
- Department of Urology, Center for Prostate Cancer, Research Institute and Hospital of National Cancer Center, Goyang, Korea
| | - Joon Chul Kim
- Department of Urology, Bucheon St.Mary's Hospital, The Catholic University of Korea, Bucheon, Korea
| | - Jong Bo Choi
- Department of Urology, Ajou University School of Medicine, Suwon, Korea
| | - Yun-Seob Song
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Kyu-Sung Lee
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Medical Device Management & Research, SAIHST, Sungkyunkwan University, Seoul, Korea
| |
Collapse
|
36
|
Loddo G, Calandra-Buonaura G, Sambati L, Giannini G, Cecere A, Cortelli P, Provini F. The Treatment of Sleep Disorders in Parkinson's Disease: From Research to Clinical Practice. Front Neurol 2017; 8:42. [PMID: 28261151 PMCID: PMC5311042 DOI: 10.3389/fneur.2017.00042] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Accepted: 01/30/2017] [Indexed: 12/29/2022] Open
Abstract
Sleep disorders (SDs) are one of the most frequent non-motor symptoms of Parkinson’s disease (PD), usually increasing in frequency over the course of the disease and disability progression. SDs include nocturnal and diurnal manifestations such as insomnia, REM sleep behavior disorder, and excessive daytime sleepiness. The causes of SDs in PD are numerous, including the neurodegeneration process itself, which can disrupt the networks regulating the sleep–wake cycle and deplete a large number of cerebral amines possibly playing a role in the initiation and maintenance of sleep. Despite the significant prevalence of SDs in PD patients, few clinical trials on SDs treatment have been conducted. Our aim is to critically review the principal therapeutic options for the most common SDs in PD. The appropriate diagnosis and treatment of SDs in PD can lead to the consolidation of nocturnal sleep, the enhancement of daytime alertness, and the amelioration of the quality of life of the patients.
Collapse
Affiliation(s)
- Giuseppe Loddo
- Department of Biomedical and Neuromotor Sciences, University of Bologna , Bologna , Italy
| | - Giovanna Calandra-Buonaura
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Bellaria Hospital, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Luisa Sambati
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Bellaria Hospital, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Giulia Giannini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Bellaria Hospital, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Annagrazia Cecere
- Bellaria Hospital, IRCCS Institute of Neurological Sciences of Bologna , Bologna , Italy
| | - Pietro Cortelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Bellaria Hospital, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Federica Provini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Bellaria Hospital, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| |
Collapse
|