Nocturia is a condition in which one feels the need to wake up at night and urinate. Medically it is defined as Getting up in night to pass urine more than once, and urination should be associated with sleep both before and after urination. It can occur in both males and females and it becomes more common as people age.
There are various reasons associated with it. Primarily it can be over production or difficulty in retaining the urine produced.
Nocturia Causes
- Excess urine production in night.
- Low bladder capacity / incomplete bladder emptying.
- Poor sleep, people with poor sleep pattern go to the bathroom whenever they wake up.
- High fluid intake especially in night
- Untreated diabetes.
- Congestive heart failure
- Edema of lower extremities (swelling of the legs)
- In-take of medicines like cardiac glycosides, demeclocycline, lithium, methoxyflurane, phenytoin, propoxyphene, and excessive vitamin D and diuretics (water pills).
- Intake of fluids like coffee, caffeinated beverages, or alcohol
- Neurological diseases affecting bladder control
- Renal failure
Symptoms
- Disturbed sleep due to recurrent need to go pee
- In men, a small urinary leakage at the end of the stream is common.
- Many women leak a little urine on coughing.
- Hesitancy, poor stream, intermittent stream, terminal dribbling.
In Nocturia the bladder is unable to hold on to the urine this is known as low nocturnal bladder capacity. This occurs due to various reasons:
- Bladder obstruction
- Bladder over activity
- Bladder infection or repeated urinary tract infection
- Bladder inflammation (swelling)
- Interstitial cystitis (pain in the bladder)
- Bladder malignancy
- A non-cancerous overgrowth of the prostate that obstructs the flow of urine (found in men)
Diagnosis
- When you visit a doctor the doctor would ask for the following details:
- Since when one is facing this problem?
- How many times one does feel the need to urinate each night?
- What is the volume of the urination each time one goes for urination (large or small)?
- Has there been a change in urination output (increase or decrease)?
- Does one take like coffee, caffeinated beverages, or alcohol and how much each day?
- Has your diet changed recently?
- In addition to this the doctor would ask one to maintain a diary on how much fluid one takes in a day, how many time he goes for urination and the volume of urination each time, this he may be asked to do for two or three days.
- The doctor will also ask for history about any type of urinary tract infections or any type of problems related to the bladder. He may even ask the patient to get some tests done in relation to these aspects.
Treatment
If one is facing the above mentioned symptoms, then he should visit a Urologist. The Urologist will advise treatment accordingly, if the problem is due to poor sleep he will refer him to a sleep specialist or pulmonologist. If not due to this he will refer him to an urologist. If there appears to be a concern for a cardiac issue, a cardiologist may be asked to check you up.
Treatment Interventions for Nocturia include:
- Restrict fluids in the evening (especially coffee, caffeinated beverages, and alcohol).
- Time management in the intake of diuretics (take mid- to late afternoon, six hours before bedtime).
- Take afternoon naps.
- Elevate the legs (helps prevent fluid accumulation).
- Wear compression stockings (helps prevent fluid accumulation).
Medications
TO BE PRESCRIBED ONLY AFTER CAREFUL ASSESSMENT AND DELIBERATION OF SIDE EFFECTS ONLY BY A MEDICAL PRACTITIONER
- Anticholinergic medications: reduce symptoms of overactive bladder
- Furosemide (Lasix): diuretics that assist in regulating urine production
- Desmopressin (DDAVP): helps the kidneys produce less urine
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