Nicturia is one of the most common urological symptoms associated with increased urinary excretion at night. The main victims of nocturia are small children under two years of age and older men after 50 years of age. But the pathology can manifest at any age and in representatives of both sexes. The reasons for such night activity are very different - from natural to pathological. Therefore, every case of nocturia requires an individual approach and special treatment. Nocturia - what is this?
Nocturia - this is not an independent disease, but just a separate symptom. It can be a consequence of an improper drinking regimen or proceed against a background of serious diseases and stressful conditions.
When a person rises to the toilet once a night, this is considered a norm option. But if the number of night hikes - from two or more, doctors are already talking about nocturia. Normally, the volume of daily urine is 2/3 of the total per day, the rest is a night "portion".With nocturia, this ratio varies noticeably in the opposite direction.
The most dangerous consequences of permanent nighttime urination are psychological. When a person a few weeks or months of standing up at night to the toilet, this leads to a serious deterioration in the quality of life.
And if nocturia is not treated, the predictions will be as follows:
- restless sleep, later insomnia;
- drowsiness throughout the day, growing into chronic fatigue;
- reduced memory and attention;
- stress and an increased risk of depression.
Causes and Symptoms
To distinguish nocturia from other similar symptoms( eg, cystitis) is very easy. If night trips to the toilet are associated with inflammation, then urination will be accompanied by discomfort and pain. Among the signs of nocturia there are no unpleasant sensations.
Most often, frequent urination overtakes young children and adult men at night. Women of reproductive age suffer from increased nighttime urination much less often. But with the onset of the retirement age, the risks of such urological pathology increase in both men and women.
Increased formation of nocturnal urine is often diagnosed in infants up to two years, less often - in children under 7 years. In the period from 7 to 15 years, nocturia occurs in only 3-5% of all patients with such a delicate problem.
In small children, nocturia often combines with urinary incontinence - enuresis. The main causes of this pathology:
- infantile bladder in infants up to 1 year( parasympathetic nervous system only formed, evacuation occurs reflexively);
- immature bladder in children 1-2 years old( the child learns to manage the processes of urination);
- very strong sleep( the child does not wake up, and urination occurs in a dream);
- low air temperature in the bedroom;
- stress situation( at a small age, all body systems, including excretory, respond to stress.
In addition, the causes of nocturia in children are often associated with inflammatory processes, with congenital diseases of the kidneys, heart defects and diabetes mellitus. That is, those causes that usually provoke a urological symptom in adults.
In many cases, nocturia in adults is a one-time phenomenon, associated with diet and drinking regimen. Drank a lot of coffee or green tea at night, ate cucumbers or watermelon or used alcohol - and the amount of nocturnal urine naturally increases.
But if the drinking regime is correct, and nocturia lasts long enough, the reasons may be:
- chronic or acute cystitis( the most common cause in women);
- kidney disease( associated with impaired concentration of kidney function);
- reception of diuretics;
- diabetes( at night, the synthesis of vasopressin - a diuretic hormone);
- decreased bladder capacity( occurs in fibrosis and cancer);
- deficiency of estrogen during menopause;
- atrophy of the pelvic floor muscles;
- cardiovascular disease.
Nicturia is almost inevitable destiny of any man. Practitioners-urologists report that nocturia in men over 50 years of age occurs in 60-70%, over 80 years - in 90%.
Causes of increased urine production in the dark and night trips to the toilet in men:
- various kidney diseases( pyelonephritis, nephrosclerosis, glomerulonephritis, etc.);
- decreased production of diuretic hormone at night( due to diabetes mellitus);
- long-term use of diuretics( diuretics);
- cardiovascular pathology;
- decrease in the structural volume of the bladder during the night;
- inflammation or prostate adenoma( enlarged prostate squeezes the urethra, preventing a full flow of urine).
The latter reason is the main reason for the diagnosis of "nocturia" in elderly men. According to urologists, about 85% of patients with prostate adenoma initially complain of frequent urination at night and related insomnia.
Traditionally distinguish two forms of nocturia - true and unstable.
With a true variety, the average daily urine volume remains at the usual level, and frequent nighttime urination is accompanied by a day oliguria. That is, the reduction or almost complete absence of urine.
Non-permanent nocturia is all cases of increased urine formation at night, in which the daily volume of fluid is not reduced. This symptom can manifest itself against the background of chronic kidney failure, diabetes, prostate adenoma, sometimes - thyroid disease and liver cirrhosis.
If constant night trips to the toilet from a non-permanent phenomenon go into a stable form, it means that the underlying disease is rapidly progressing. The most dangerous signal is when nocturia disappears in cardiovascular pathologies and at the same time there are constant swelling. This indicates a serious stage of the disease, requiring urgent medical intervention.
In order to diagnose "nocturia", the doctor must clearly know the volume of the patient's day and night urine and establish their correlation. For this, a collection of urinalysis is used for Zimnitskiy.
Before the test, you must stop taking diuretics, you can not increase the patient's usual volume of fluid. The optimal amount is 1-1.5 liters of fluid per day. We will have to delete from the menu products that provoke thirst: sweet, salty, spicy, etc.
There should be 8 containers with urine for the following periods:
If there is a suspicion of kidney disease or other organs, the doctor may prescribe additional procedures: urine, blood, ultrasound, etc. Older patients also require an analysis for vasopressin - a diuretic hormone.
It is also recommended to maintain a special diary where there is a drinking regimen( the amount of fluid consumed) and the number of night trips to the toilet.
Since nocturia in most cases is only a signal about an existing disease, it is necessary to identify the root cause before treating it. For this, antibiotics( if there is an infection), hormonal drugs, herbal preparations, etc. are used.
To eliminate the very nocturia, antidepressants, sleeping pills( if there is a sleep disorder), M-holinoblokatory and other groups of drugs are prescribed. M-holinoblokatory block the receptors of muscarin on the walls of the bladder, reducing its tone. At night, spasms of the sphincter of the bladder does not occur, there is no urge to urinate, and the patient sleeps quietly.
For men who have nocturia caused by prostatic adenoma, groups of drugs such as α1-adrenoreceptor antagonists and 5α-reductase inhibitors are recommended. The first relax the muscles of the prostate and bladder, reducing the compression of the urethra and, accordingly, reducing the amount of urge to urinate.
To prevent the occurrence of nocturia or to weaken already appeared, doctors recommend to follow preventive measures:
- Strengthen the muscles of the small pelvis( especially for women).
- Avoid hypothermia, not to provoke inflammation of the bladder.
- Do not drink a lot of liquids at night( the last glass of water or a cup of tea - 2-3 hours before bedtime).
Inflammation of the kidneys or uterine appendages( in women) can also be treated with folk remedies: a decoction of the leaves of black currant, parsley, etc. But if you are not sure of your diagnosis, you must first consult a doctor.
Doctors usually do not advise doctors to treat nicturia with medicines. It is important to exclude from the life of the child all stressful situations, provide him with comfortable sleeping conditions: warm pajamas, the temperature in the bedroom is not lower than 20ºC.And also to comply with the drinking regime: the last glass of liquid 3 hours before bedtime, before going to bed - compulsory visit to the toilet.
On the video about the causes, symptoms, treatment of nocturia: