Nocturia - Enuresis - Overactive Bladder
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Nocturia - Enuresis - Overactive Bladder
NIH - Medical Encyclopedia Urination - excessive at night
"Normally, urine decreases in amount and become more concentrated at night. That means, most people can sleep 6 to 8 hours without having to urinate. But, persons with nocturia get up more than once during the night to urinate. Because of this, those who have excessive urination at night often have disrupted sleep cycles. Common Causes • Benign prostatic hyperplasia • Certain drugs including diuretics, cardiac glycosides, demeclocycline, lithium, methoxyflurane, phenytoin, propoxyphene, and excessive vitamin D • Chronic or recurrent urinary tract infection • Chronic renal failure • Congestive heart failure • Cystitis • Diabetes • Drinking too much fluid before bedtime, particularly coffee, caffeinated beverages, or alcohol • Obstructive sleep apnea and other sleeping disorders"
NIH - Medical Encyclopedia Bedwetting
"Bedwetting is involuntary urination in children over 5 to 6 years old. It may occur at any time of the day or night. This article focuses on nighttime bedwetting. … Children who have never been consistently dry at night have primary enuresis. This usually occurs when the body makes more urine overnight than the bladder can hold and the child does not wake up when the bladder is full. The child's brain has not learned to respond to the signal that the bladder is full. It is not the child's or the parent's fault. Physical causes are rare, but may include lower spinal cord lesions, congenital malformations of the genitourinary tract, infections of the urinary tract, or diabetes. Bedwetting runs strongly in families. More than 5 million children in the U.S. wet the bed. About 9% of boys and 6% of girls still wet the bed at age 7. The numbers drop slightly by age 10. Although the problem goes away over time, many children and even a small number of adults continue to have bedwetting episodes."
Highlighted Articles
Me and My Kegels; Doing pelvic exercises the right way can pay off in the bathroom—and the bedroom.
"Two years after giving birth, I still can’t control my bladder. I’m one of 25 million Americans, the majority of them women, with incontinence. More than half of healthy women ages 42 to 50—I’m 45—have some form of chronic-peeing problem, usually linked to pregnancy and childbirth, coughing, constipation, heavy lifting, or hormonal changes. Yet, incredibly, 90 percent of us never seek treatment."
"Kegel exercises strengthen some of the muscles that control the flow of urine. Doctors often prescribe Kegel exercises for people who have bladder control problems (urinary incontinence). Kegel exercises are also called pelvic floor exercises because they treat and prevent pelvic floor weakness "
Effects of walking exercise on nocturia in the elderly.
(Biomed Res. 2007) "The daytime urinary frequency, blood pressure, body weight, body fat ratio, edema ratio, serum catecholamines, triglycerides, and total cholesterol were also decreased. After 8 weeks of exercise, 20 of the subjects (67%) stated that sleep was deeper than before exercise. Assessment of the overall improvement showed that excellent or good results were obtained in 18 patients (60%). The main factor related to the influence of walking exercise on nocturia was that sleep became deeper, which increased the arousal threshold bladder volume. Walking exercise may also have a preventive effect on lifestyle-related diseases."
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Nocturia, Enuresis and Overactive Bladder
General Information
NEWS:
Baby Boom Women Confronting Pelvic Health Conditions "The report said an estimated 33 percent of Baby Boom women have stress urinary incontinence, but only about 47 percent of all women have ever asked their doctor about it. Many women don't realize that treatment may be as simple as floor exercises or biofeedback, or that surgical interventions are also available, the report said. Some statistics show that as many as 40 percent of women between the ages of 50 and 79 have some form of pelvic prolapse, the report added. But only about 10 percent to 20 percent of women seek medical care, which includes surgical and non-surgical treatments, the report added. "
ARTICLES:
Overactive Bladder: A Quality of Life Quiz
JOURNAL ARTICLES:
Age Related Pathogenesis of Nocturia in Patients With Overactive Bladder. (J Urol. 2007) "CONCLUSIONS: In younger patients with overactive bladder, decreased nocturnal bladder capacity has a greater role in the pathogenesis of nocturia symptoms, whereas in older patients increased nocturnal urine output has a greater role."
Bed-wetting in Chinese children: Epidemiology and predictive factors. (Neurourol Urodyn. 2007)
Behavioral Comorbidity Differs in Subtypes of Enuresis and Urinary Incontinence. (J Urol. 2007)
Biochemical and body composition analysis of nocturia in the elderly. (Neurourol Urodyn. 2007) "RESULTS: The features specific to the elderly nocturia group are as follows: (1) a decrease of the nighttime plasma melatonin level, (2) an increase of nighttime plasma catecholamine levels, (3) an increase of daytime and nighttime plasma natriuretic peptide levels, (4) an increase of blood pressure, (5) a decrease of daytime and nighttime urinary osmotic pressure, (6) an increase of total urine volume, and (7) an increase of the edema ratio before sleeping. CONCLUSIONS: These results suggest that sleep disturbance, hypertension, and excessive fluid intake are major factors contributing to an increased frequency of nocturnal urination (>twice per night) in the elderly."
Bladder sensory desensitization decreases urinary urgency. (BMC Urol. 2007) "Urgency is being recognised as the fundamental symptom of overactive bladder (OAB), a symptomatic complex which recent epidemiological studies have shown to affect more than 10% of the Western population. As anti-muscarinic drugs, the first line treatment for OAB, are far from being able to fully control urgency, the opportunity to test other therapeutic approaches is created. The present work was, therefore, designed as an exploratory investigation to evaluate the effect of bladder desensitization on urinary urgency."
Defining overactive bladder as hypersensitivity. (Neurourol Urodyn. 2007) "Overactive bladder (OAB), according to the International Continence Society (ICS) definition, is a symptom syndrome, with urgency as the cornerstone symptom. However, the word 'urgency' and its definition continue to be the subject of much debate and confusion. It is generally difficult for patients to differentiate urgency from normal urge, particularly when the desire to void is strong. … We therefore hypothesized that OAB may be more accurately defined as a hypersensitivity disorder rather than a syndrome characterized by urgency."
Diagnosis of interstitial cystitis/ painful bladder syndrome in patients with overactive bladder symptoms. (Rev Urol. 2007)
Diuretic pattern in adults with nocturnal polyuria: The possible contribution of blood pressure to the worsening of nocturnal polyuria (International Journal of Urology 2007) "These results indicate that blood pressure might play an important role as a determinant of increasing nocturnal diuresis in NP."
Evaluation of sexual function in women with overactive bladder syndrome. (Urol Int. 2007) "Conclusion: The results indicate that there is a trend toward lower sexual function scores in women with OAB compared to controls."
Imaging bladder sensations. (Neurourol Urodyn. 2007) "Normal bladder filling sensations are mapped mainly in the insula, shifting anteriorly as sensation becomes stronger and more unpleasant. In subjects with poor bladder control, sensations and brain responses are different from normal. Responses are relatively small at low bladder volumes (with mild sensation), but become exaggerated (with strong sensation) above a certain volume threshold, even when there is no actual detrusor overactivity."
Impact of Nocturia on Sleep and Energy (European Urology Supplements 2007)
It's just the worry about not being able to control it! A qualitative study of living with overactive bladder. (Br J Health Psychol. 2007)
Nocturia: Etiology, diagnosis, and treatment. (Neurourol Urodyn. 2007) "In general, the causes of nocturia fall into three categories: diurnal polyuria, nocturnal polyuria, and low bladder capacity. In some individuals, however, nocturnal polyuria and low bladder capacity may both contribute to the overall symptomatology of nocturia. Addressing any underlying conditions that contribute to nocturia is the first step in treating the condition. Lifestyle and behavioral changes may provide benefit in some individuals, but for many, the only option is pharmacotherapy. Antimuscarinic agents are first-line therapies for overactive bladder and are often used in the management of nocturia."
Nocturnal Polyuria is Related to 24-Hour Diuresis and Osmotic Excretion in an Enuresis Population Referred to a Tertiary Center. (J Urol. 2007)
Nocturnal Polyuria is Related to Absent Circadian Rhythm of Glomerular Filtration Rate. (J Urol. 2007)
Normative bladder diary measurements: Night versus day. (Neurourol Urodyn. 2007) "The night increase is much steeper than the day increase. With aging, frequency increases, V(avg) decreases, day production decreases and night production increases. These age effects are steeper for males than females."
Overlap of Voiding Symptoms, Storage Symptoms and Pain in Men and Women. (J Urol. 2007)
Pathophysiological Aspects of Nocturia in a Danish Population of Men and Women Age 60 to 80 Years. (J Urol. 2007)
Polyuria and polydipsia in a 5 year-old child: diagnostic problems. (Minerva Pediatr. 2007)
Prevalence and behavioural correlates of enuresis in young children. (J Paediatr Child Health. 2007)
Prevalence and impact of nocturia in a urogynecologic population. (Int Urogynecol J Pelvic Floor Dysfunct. 2007)
Prevalence of nocturia in a Korean population aged 40 to 89 years. (Neurourol Urodyn. 2007) "RESULTS: Of 2005 subjects (1,005 women and 1,000 men) interviewed, 33.5% reported voiding once per night and 48.2% twice or more per night. Nocturia increased with age among both genders and was more common among young women than young men. In all subjects, multivariate analysis indicated that female gender, older age and an overweight condition were independent risk factors. Body mass index was associated with an increased likelihood of nocturia in male but not in female subjects. In female subjects, the likelihood of at least one night-time void was related to delivery number (odds ratio 1.17, 95% confidence interval 1.04-1.32)."
Prevalence of nocturia in taiwanese women aged 20-59 years. (Taiwan J Obstet Gynecol. 2007) "CONCLUSION: Nocturia is a common condition among Taiwanese women, especially among the elderly. Its prevalence is significantly related to age. Treatment of this condition in this patient population can both improve their quality of life and reduce the risk of deterioration in their general state of health."
Prevalence of storage and voiding symptoms among men aged 40 years and older in a US population-based study: results from the Male Attitudes Regarding Sexual Health study. (Int J Clin Pract. 2007) "Aims: Lower urinary tract symptoms (LUTS) are categorised as storage (urgency, frequency, nocturia and incontinence), voiding (sensation of incomplete emptying, hesitancy, weak stream and straining) or mixed symptoms."
Seasonal changes in symptom score and uroflowmetry in patients with lower urinary tract symptoms. (Scand J Urol Nephrol. 2007)
The association of nocturia with cardiac disease, diabetes, body mass index, age and diuretic use: results from the BACH survey. (J Urol. 2007) "CONCLUSIONS: Nocturia is common and associated with decreased quality of life. When planning treatment, clinicians should consider causes of nocturia outside of the lower urinary tract."
The epidemiology and factors associated with nocturnal enuresis and its severity in primary school children in Taiwan. (Acta Paediatr. 2007)
The Impact of Maturation of Brainstem Inhibition on Enuresis: A Startle Eye Blink Modification Study With 2-Year Followup. (J Urol. 2007)
The Prevalence of Attention Deficit-Hyperactivity Disorder in Children With Nonmonosymptomatic Nocturnal Enuresis: A 4-Year Followup Study. (J Urol. 2007) "CONCLUSIONS: At 4-year followup a substantial number of children still met the criteria for attention deficit-hyperactivity disorder, even after becoming dry. The prevalence rate of enuresis decreased much faster than that of attention deficit-hyperactivity disorder, suggesting the presence of a psychiatric syndrome rather than a coping behavior. Contrary to intermediate findings, current enuresis status could no longer be predicted by attention deficit-hyperactivity disorder symptoms."
Voiding patterns in men and women with lower urinary tract symptoms combined with nocturia. (Int J Urol. 2007)
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