Nocturia
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| Nocturia | |
| ICD-10 | R35 |
|---|---|
| ICD-9 | 788.43 |
Template:Search infobox Steven C. Campbell, M.D., Ph.D.; Associate Editor(s)-in-Chief: Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [1]
Overview
Nocturia (derived from Latin nox, night, and Greek [τα] ούρα, urine), also called nycturia (Greek νυκτουρία), is the need to get up during the night in order to urinate, thus interrupting sleep. Its occurrence is more frequent in the elderly. Nocturia could result simply from too much liquid intake before going to bed, or it could be a symptom of a larger problem, such as chronic renal failure, urinary incontinence, Interstitial Cystitis, diabetes, benign prostatic hyperplasia, Ureteropelvic junction obstruction[1] or prostate cancer.
Pathophysiology
Causes
Causes by Pathogenesis
| Causes of Nocturia | |||||||||||||||||||||||||||||||||||
| Due to Hormonal imbalance | Due to Vesical problems | ||||||||||||||||||||||||||||||||||
| Global Polyuria | Nocturanl Polyuria | Sleep disorders | Bladder storage disorders | ||||||||||||||||||||||||||||||||
Causes Due to Hormonal Imbalance
| Global Polyuria | Nocturnal Polyuria | Sleep disorders |
|---|---|---|
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Defined as a 24-hour urine volume that exceeds 3 liters per day (or 40 mL per kg).The common causes of global polyuria are
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Nocturnal polyuria is defined as an increase in urine production during the night but with a proportional decrease in daytime urine production that results in a normal 24-hour urine volume. Nocturnal polyuria may be due to age-related changes in the secretion and action of arginine vasopressin (AVP). There is a diurnal periodicity in AVP release in young, healthy subjects, with higher AVP plasma levels in the evening contributing to decreased nighttime urine output.The diurnal variation in AVP release is absent in many older people. Compared with the normal patients, nocturia patients have a nocturnal decrease in AVP level. Other causes of nocturnal polyuria include diseases such as
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Sleep disorders have been demonstrated to be a frequent cause of nocturia in men younger than 50 years and in women with symptoms of daytime overactive bladder syndrome. Primary sleep disorders may result in nocturia either because of hormonal changes related to sleep-disordered breathing or due to patient misperception of the reason for awakening due to the sleep disturbance but recall this as an awakening to void. e.g. OSA may also cause nocturnal polyuria by release of atrial natriuretic peptide (ANP). |
Causes Due to Vesical Problems
| Bladder storage disorder |
|---|
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Reduced bladder capacity or impaired bladder function results in low-volume voids. Most common causes of low-volume bladder voids are
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Causes by Organ System
| Cardiovascular | Heart failure |
| Chemical/Poisoning | No underlying causes |
| Dental | No underlying causes |
| Dermatologic | No underlying causes |
| Drug Side Effect | Bicalutamide, Cardiac glycosides, Demeclocycline, Diuretics, Excessive vitamin D intake, Lithium, Methoxyflurane, Phenytoin, Propoxyphene, Tiagabine |
| Ear Nose Throat | No underlying causes |
| Endocrine | Liver failure |
| Environmental | No underlying causes |
| Gastroenterologic | No underlying causes |
| Genetic | No underlying causes |
| Hematologic | No underlying causes |
| Iatrogenic | No underlying causes |
| Infectious Disease | Interstitial cystitis, Recurrent UTI |
| Musculoskeletal/Orthopedic | No underlying causes |
| Neurologic | Detrusor hyperactivity, Diabetes insipidus, Neurogenic bladder , Parkinson disease, Restless leg syndrome, Urge incontinence |
| Nutritional/Metabolic | Diabetes, Obesity |
| Obstetric/Gynecologic | No underlying causes |
| Oncologic | Prostate cancer |
| Ophthalmologic | No underlying causes |
| Overdose/Toxicity | No underlying causes |
| Psychiatric | Anxiety disorders, Depression, Obstructive sleep apnea, Primary polydipsia |
| Pulmonary | No underlying causes |
| Renal/Electrolyte | Chronic renal failure, Diabetes insipidus, Nephrotic syndrome |
| Rheumatology/Immunology/Allergy | No underlying causes |
| Sexual | No underlying causes |
| Trauma | No underlying causes |
| Urologic | Benign prostatic hyperplasia, Bladder outlet obstruction, Detrusor hyperactivity, Granulomatous prostatitis, Interstitial cystitis, Neurogenic bladder, Prostate cancer, Ureteropelvic junction obstruction |
| Miscellaneous | Learned voiding dysfunction, Venous insufficiency |