Incidence Of Nocturia Research Articles

Depressive Symptoms Increase the Incidence of Nocturia: Tampere Aging Male Urologic Study (TAMUS)

We assessed the effects of depressive symptoms on the incidence of nocturia in men. The target population comprised all men who were 50, 60 or 70 years old and residing in the Tampere area in 1994. A self-administered questionnaire was mailed to 3,143 randomly selected men in 1994 and a second round was mailed to the 2,837 who were alive and eligible in 1999. The followup sample consisted of 1,580 men with information on nocturia available at baseline and followup. The incidence of mild to severe nocturia was 75 cases per 1,000 person-years (95% CI 66-85) and that of moderate or severe nocturia was 9 (95% CI 7-11). Men with depressive symptoms at study entry were at 2.8 times higher risk (95% CI 1.5-5.2) for moderate or severe nocturia than those without depressive symptoms. A dose response relation was found between the severity of depressive symptoms at baseline and the incidence of moderate or severe nocturia. Each unit increment in the short form of the Mental Health Inventory score on a scale of 5 to 30 increased the incidence rate ratio of moderate or severe nocturia by 10% (95% CI 4-16). Only untreated depressive symptoms increased the incidence of moderate or severe nocturia (adjusted RR 3.3, 95% CI 1.7-6.2) but not medically treated symptoms. Nocturia at study entry had no significant effect on depressive symptoms during followup. Our findings show a unidirectional effect of depressive symptoms on the incidence of moderate or severe nocturia. Untreated depressive symptoms may cause nocturia.

The Prevalence and Risk Factors of Nocturia for Males Participating in a Prostate Examination Survey

Purpose: Elderly men are often troubled by lower urinary tract symptoms (LUTS), including frequency, urgency, incontinence and nocturia. Especially, nocturia is one of the frequently complained about urologic symptoms and this can be combined with sleep disorders. We investigated the prevalence and risk factors for nocturia in males who participated in a prostate examination survey. Materials and Methods: A total of 7,299 men participated in a prostate examination survey from March 2003 to December 2006; these men were given an International Prostate Symptom Score (IPSS) and they underwent transrectal ultrasonography of the prostate. The prevalence of nocturia and its associated factors, which included age, the IPSS severity, the prostate volume and the place of residence, were evaluated. Results: Among the men who were evaluated, 23.4% reported voiding once per night and 68% reported voiding twice or more per night. The severe IPSS group revealed a significantly higher nocturia score compared to the mild and moderate IPSS group. While the nocturia score and the other LUTS score increased significantly with age, only the nocturia score increased significantly with age in each of the IPSS severity groups. The nocturia score increased significantly with a prostate volume ≥30g. Men living in Seoul showed a significantly lower nocturia score than that for men living in other areas. Multiple logistic regression analysis also indicated that an older age, a severe IPSS score, the country of residence were the independent risk factors. Multiple regression analysis revealed the nocturia score to have the highest correlation with the quality of life. Conclusions: For Korean males, the prevalence of nocturia ≥2 is 68% and the incidence of nocturia increased significantly according to age, the IPSS severity, the prostate volume and the place of residence. (Korean J Urol 2008;49:818-825) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

Nykturia u chorych na obturacyjny bezdech senny (OBS)

Nocturia (two or more urinations per night) is a common symptom in OSA subjects. Higher secretion of atrial natriuretic peptide, increased intra-abdominal pressure, diuretics, diabetes, excessive fluid intake, awakenings are responsible for nocturnal urination. The aim of this study was to evaluate incidence of nocturia in moderate and severe OSA. We studied 171 consecutive OSA patients (135 males and 36 females) - means: age - 53.6 +/- +/- 10.8 years, AHI/RDI - 43.6 +/- 23.2, BMI - 35.8 +/- 6.3 kg/m(2). To assess relations between nocturia and AHI/RDI, overnight saturation, BMI and daytime sleepiness we divided subjects in two groups: 1(st) - without nocturia - 60 pts; 35.1% (group N-) and 2(nd) - with nocturia - 111 pts; 64.9% (group N+). Group N+ presented with higher AHI/RDI, 48 +/- 22.8 vs. 35.4 +/- 21.7 (p = 0.0006), higher BMI, 36.8 +/- 6.5 vs. 34 +/- 5.5 kg/m(2) (p = 0.004), lower mean overnight SaO(2), 88.6 +/- 5.6 vs. 90.4 +/- 4.3% (p = 0.03) and daytime sleepiness, Epworth score - 14.4 +/- 5.1 vs. 11.3 +/- 5.5 points (p = 0.0002). Multiple linear regression analysis revealed significant correlation between nocturia and Epworth sleepiness score (beta = 0.26, p = 0.0009), coronary artery disease (beta = 0.23, p = 0.004) and AHI/RDI (beta = 0.21, p = 0.04). Nocturia is frequent in OSA patients (64.9%). Nocturnal urination was related to severity of OSA, excessive daytime sleepiness and coronary artery disease.

TREATMENT OF URINARY INCONTINENCE FOLLOWING SPINAL CORD INJURY WITH TRADITIONAL PHYSICAL THERAPY TECHNIQUES

Background & Purpose: The prevalence of neurogenic bladder has been reported in up to 81% of individuals with spinal cord injury (SCI), and is a common contributor to rehospitalization and death. Physical therapy (PT) interventions such as pelvic floor muscle (PFM) strengthening, behavioral training, and surface electrical stimulation can improve continence in neurologically intact individuals. However, no studies on the efficacy of PT for urinary incontinence in SCI have been reported. The purpose of this case report is to describe the successful PT management of an individual with urinary incontinence resulting from SCI. Case Description: The patient was a 61 year-old female who sustained a L2, non-traumatic SCI 22 months prior to our intervention. She reported urinary incontinence as a result of the SCI, including 7–8 episodes of urge incontinence daily, stress incontinence during coughing, transfers, and sneezing, leakage of urine throughout the day, and nocturia 3–5 times a night. Examination demonstrated lower extremity motor scores of 21/50 and she was intact to both light touch and sharp sensation in dermatomes S3 and S4-5. The anal wink reflex was intact bilaterally. PFM evaluation revealed a 4/5 muscle score in all four quadrants with no significant muscular or structural abnormalities. The patient underwent standard PT interventions for the treatment of urinary incontinence. Behavioral training included avoidance of bladder irritants, a timed voiding schedule, fluid management, and dietary modifications. PFM training consisted of biofeedback, muscle re-education, and strengthening exercises. Surface electrical stimulation was performed by applying 2 electrodes over the right S2-4 nerve roots for 15 minutes daily. Four treatment sessions of PT were conducted over four weeks. Outcomes were measured by subjective reports of severity of incontinence and reports on a voiding diary. Outcomes: After four PT sessions, the subject reported urinary incontinence less than once a day and no incidence of nocturia. At a five month follow-up, she reported that she continued the daily PFM exercises and behavioral training, and performed electrical stimulation every 7–10 days. Incontinent episodes occurred less than once weekly, without urgency or nocturia. She no longer needed to use assistive devices, such as Depends, pads, or chucks. Discussion: In four PT treatments, severity of urinary incontinence decreased substantially. The combination of multiple PT techniques appeared to be successful in the reduction of incontinence. The chronicity of her injury suggests that spontaneous improvement is unlikely to explain her positive response to the interventions. The patient's positive outcomes may be related to the relatively low spinal level of the SCI and partial preservation of sensory and motor function to the perineum. These results warrant consideration of standard PT pelvic floor rehabilitation interventions for the treatment of urinary incontinence in individuals after SCI.

Incidence of Nocturia in 50 to 80-Year-Old Finnish Men

We estimated the incidence and natural course of nocturia in an unselected Finnish male population. A mail interview of a cohort of 3,143 randomly selected men 50 to 70 year old at study entry was done in Finland in 1994, 1999 and 2004. The questionnaire included questions on sociodemographic status, overall health and disease, urinary symptoms, sexual functioning and symptom bother. The overall response rate was 70% on the 1994 survey, 75% on the 1999 survey and 76% on the 2004 survey. A response to nocturia questions was obtained from 1,633 men at the 1994 to 1999 followup and from 1,618 at the 1999 to 2004 followup. The overall prevalence of 1 or more nocturnal voidings was 56% at baseline and 74% 10 years later. The crude incidence rate for nocturia was 75 new cases per 1,000 men annually (95% CI 66 to 85) during the first 5-year followup period and 126/1,000 (95% CI 113 to 140) during the second period. The incidence of moderate or severe nocturia was 9/1,000 (95% CI 7 to 11) and 14/1,000 men (95% CI 12 to 17), respectively. Incidence and prevalence increased clearly with age but also by calendar time, which was most prominent for the mild nocturia incidence. The incidence of moderate to severe symptoms increased, especially in the oldest cohort (incidence density ratio 5.6 to 5.7/5 years). Every year 10% more males older than 50 years start to void during the night. The incidence of mild nocturia increases, especially in men when they age from 50 to 60 years. In older men mild symptoms are more stable but the incidence of severe nocturia increases strongly after age 75 years.

Epidemiology of nocturia

The incidence of nocturia episodes increases with age and is associated with interrupted sleep and distress. There are no large differences in the incidence of nocturia between men and women, but young women tend to have it more frequently than young men, and very old men have it more often than very old women. The International Continence Society has defined nocturia as 'the number of voids recorded during a night's sleep: each void is preceded and followed by sleep.' This simple and useful definition should facilitate further epidemiological study of nocturia. Although there are many direct prevalence studies of nocturia, there is a great need for more advanced analytical epidemiological data on risk factors and comorbidity. Clinicians should question patients about nocturia and should consider this symptom in a broader sense than in its traditional association with benign prostatic obstruction in men and incontinence in women. There are several classic studies of nocturia. The nature of future epidemiological research will depend on the resolution of several methodological issues. Further evaluation of nocturia is warranted because of its high incidence among the general adult population.

Lower urinary tract symptoms after renal transplantation: are there changes over time?

Objectives To examine the changes in bladder function after renal transplantation by comparing lower urinary tract symptoms in the first and third years after transplantation in a group of renal transplant recipients. Methods The long-term changes in bladder function after transplantation were studied using a longitudinal study design. The study group consisted of 53 patients who underwent renal transplantation in 1998 at the University Medical Centre Nijmegen and who returned a completed questionnaire about their micturition pattern in the first and third year after transplantation. The data on symptoms of lower urinary tract dysfunction were collected using the International Continence Society (male) and Bristol Female Lower Urinary Tract Symptoms questionnaires. The control group consisted of 74 patients who visited the Outpatient Clinic of Otorhinolaryngology at year 1. In our analyses, we compared the micturition behavior of the transplant group at year 3 with the control group and with their own micturition behavior at year 1. Results The results of our study showed that 3 to 4 years after transplantation, the renal transplant group still urinated significantly more often during the day and during the night than did the control patients. Furthermore, among most (63% to 68%) of the patients who showed these symptoms in the first year after transplantation, the symptoms were still present 2 to 3 years later. Conclusions The frequency and incidence of nocturia among renal transplant patients are fairly persistent phenomena.

Triazolam and Nitrazepam Use in Elderly Outpatients

To determine adverse reactions and effects on sleep among three groups of patients: those taking triazolam, those taking nitrazepam, and a control group. Telephone interviews. Forty-seven patients taking triazolam, 36 taking nitrazepam, and 40 control patients. All study participants were outpatients over 60 years of age. The rate of awakening in the middle of sleep was not significantly different among patients taking triazolam (61.7 percent) and those taking nitrazepam (69.4 percent). Incidence of nocturia, the primary reason for awakening, was not significantly different between triazolam- (36.2 percent) and nitrazepam-taking patients (41.7 percent). The rate of having difficulty falling back to sleep was significantly different among triazolam (62.1 percent) and nitrazepam (8 percent), and triazolam and control (11.1 percent) groups (p < 0.01). No difference was evident, however, between nitrazepam and control groups. Patients taking nitrazepam have less difficulty returning to sleep compared with those who take triazolam. Thus, for elderly patients who awaken because of nocturia, nitrazepam may be more appropriate therapy.

Studies of nocturia in normal pregnancy.

SummaryObservations were made on mean urine flow and the urinary excretion of total solute, sodium, potassium, urea and glucose in a 24 hour study and in an overnight study, each involving 100 pregnant and 100 non‐pregnant women. The findings reveal that the major cause of nocturnal frequency of micturition in the first and second trimesters is an increase in overnight urine flow, the increment being large in comparison with the change in 24 hour output. Overnight sodium excretion was also raised and was mainly responsible for the increase in urine flow. There was a reduction in the overnight excretion of urea relative to total solute excretion in the first and second trimesters and an absolute reduction in both overnight and 24 hour urea excretion in the third trimester; the significance of this observation is discussed. In a survey of 873 pregnant patients, the incidence of nocturia in the first, second and third trimesters was respectively 58, 57 and 66 per cent. Although the increment in mean overnight urine flow was smallest in the third trimester, measurements of urine voiding volumes suggest that in late pregnancy a decrease in functional bladder capacity is an additional cause of nocturia.