Effective Nocturia Treatment
Seeking effective Nocturia treatment is something that, unfortunately, many patients with nocturia fail to do. This is partially because nocturia is a condition, which has not been receiving as much medical attention as other urinary disorders. Nocturia is simply defined as frequent urination during the night. Non specific terms such as “frequent” naturally create patient confusion and some diagnostic challenges. Medical professionals have attempted to clear the confusion by defining frequent as waking two or more times during the night to go to the bathroom. However, a more appropriate guide for patients is to simply notice when nightly urination disturbs a their sleep, and this is the appropriate time to seek medical help for prescription of one of the many available nocturia treatments.
The options available for treating nocturia depend largely on the underlying causes. The first step in prescribing the appropriate nocturia treatment is always the proper identification of the type of nocturia. Essentially, there are three large categories under which excessive night-time urination can be classified, which are as follows: increased night time urinary volume (nocturnal polyuria), decreased urinary holding capacity of the bladder during the night, or an increased total daily volume of urine. Physicians initially ask the patients to keep a twenty four hour voiding diary in which the volume voided is recorded along with the time of the voiding and the degree of urgency felt during the urination.
This simple diary allows the physician to determine whether the patient has polyuria (increase in the volume of urine) due to general systemic causes. In the instances where nocturia (the increase in the urination frequency at night) is simply a part of a 24-hour increase in volume of urine then the success of nocturia treatments will depend solely on the identification and management of the cause of polyuria. The most common cause of an increased urinary volume is diabetes mellitus, followed by a condition known as diabetes insipidus.
If, according to the 24 hour urinary output diary, the volume if urine voided during the night is estimated to be more than one third of the total urinary volume voided, then the patient is said to have nocturnal polyuria. Nocturnal polyuria is common in patients with heart failure, a sleep disorder known as obstructive sleep apnoea, and patients with problems with drainage of the lower limb veins. All these conditions are thought to initiate a series of hormonal events responsible for decreasing urinary concentration at night and increasing urine volume. The available nocturia treatment for these patients include simple measures such as restricting fluid intake during the night, measures to reduce fluid build up in the lower limb such as elevation of the legs, wearing compression stockings, and taking afternoon naps. Some medications such as diuretics taken in the afternoon may also prove helpful as nocturia treatments. Other medications, such as Desmopressin or Melatonin, have also been used as nocturia treatments in patients with Nocturnal polyuria.
Some interventional nocturia treatments are also available for resistant cases. The most recent being a device, known as InterStim, which preliminary studies have shown that it has a success rate of close to 60% in controlling nocturia.
Tagged with: nocturia
Filed under: Incontinence