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Nocturia, what is it? Symptoms in women and men, treatment, drugs

Nocturia - what is it?

A healthy organism of an adult person releases up to 80% of urine per day from the total amount of fluid consumed per day. The ratio of the amount of urine released during the daytime and at nighttime differs by almost a third - 2/3 day and 1/3 night. When the ratio changes, and night urination exceeds the daily rate - this is nocturia.

Depending on the etiological factor, nicturia is classified as cardiac, developing on the background of low contractile function of the heart muscle and renal, caused by renal pathologies.


Nocturia causes - common and nocturnal forms


The causative factors of nocturia are due to - the effect of hormonal imbalance and problems associated with the functional state in the structure of the bladder. The regulation of water balance in our body is carried out by two hormones - vasopressin (antidiuretic hormone) “AVP”, produced by the posterior lobe of the pituitary and atrial natriuretic (“ANG”) hormone.

The action of the hormone "AVP" is due to the increased effect of absorption (absorption) of fluid in the tubular renal system (renal glomeruli), reducing the excretory functions of the kidneys and reducing the secretion of uric acid. This hormone performs the functions of regulating the level of water saturation of the body.

But when cardiac muscle tissue is oversaturated with cardiac abnormalities in blood, the release of natriuretic hormones occurs. When these hormones are activated, the processes of water release and an increase in the secretion of urine occur. The causes of nocturnal nocturia are due to four fundamental factors:

  1. General polyuria, when the increase in urine output per day depends on a number of clinical signs of renal and neuro-endocrine disorders.
  2. Nighttime polyuria due to increased urine flow at night.
  3. Violations in the bladder, depriving him of the ability to retain urine.

General and nocturnal polyuria develops as a result of the imbalance of the hormone level “WUA” or “ANG”. The third point is due to pathological processes in the bladder.

night polyuria

In simple terms, this can be explained with simple examples. With nocturia cardiac, in patients during the daytime cardiac loads and fluid intake increase, which contributes to stagnant processes of blood and water in tissue structures.

At night, when a person lays the load on the heart decreases, the outflow of venous blood improves, which contributes to the release of atrial natriuretic "ANG" hormone. This leads to an increased diuresis (an increase in the volume of urine excretion) and a decrease in puffiness.

In renal pathology nocturia, caused by renal pathologies, at night the blood flow in the affected renal tissues improves, its movement through the renal vessels is accelerated. The development of hypertensive diuresis begins, increasing urine excretion up to twelve times.

Violations in the ratio of urine excretion by day and night is considered a functional norm only in nocturia in children, and then only until the age of two. In all other cases, this unpleasant symptom of nocturia indicates the presence in the body of serious pathological changes that require urgent diagnosis and treatment.

Signs of Nocturia in Men

Signs of Nocturia in Men

Violation of the quantitative ratios of the allocation of urine in the direction of increased toilet trips at night, in men appears (in most cases) in adulthood. Develops early signs of quantitative leveling of urination during the day and night visits to the toilet at night.

The development of provoking factors leads to a gradual increase (almost by a third) at night, disrupting sleep and bringing the “strong half of humanity” to nervous breakdowns and depressive states.

This condition can be triggered by a number of pathological reasons:

  • the failure of the heart muscles to pump enough blood and to ensure the proper processes of tissue metabolism, provoking congestive processes and swelling;
  • impaired blood passage through the vessels that supply the heart muscle with atherosclerotic formations (plaques);
  • a consequence of sleep apnea syndrome;
  • renal disease;
  • steroid hormone deficiency;
  • pathologies of the nervous system in the form of multiple sclerosis ;
  • behavioral factors - the use of alcoholic beverages, caffeine and a large amount of fluid just before bedtime.

An important factor among the causes of nocturia is a decrease in the structural capacity of the cavity of the bladder, provoked by: fibrous and malignant neoplasms, the use of medical techniques of ionized radiation, pathological processes in the lower zones of the urethra, obstructions in the neck of the bladder.

Pathological changes in this organ are accompanied by episodic phase symptomatology of nocturia, being expressed by emptying and accumulative signs.

Emptying signs appear:

  • prolonged delay immediately before the act of urination;
  • a trickle of urine exit;
  • The "terminal" stage of emptying - a drop of urine;
  • involuntary release of urine dropwise, after the process of urination;
  • feeling not complete exit of urine.

Accumulative symptoms are characterized by:

  • frequent urination;
  • an increase in trips to the toilet at night;
  • imperative urges (failure of long urinary retention);
  • imperative urinary incontinence (inability to control, urination often occurs before reaching the toilet).

Symptoms of nocturia in women

Symptoms of nocturia in women

Women are distinguished by a more sensitive urogenital system, which sharply reacts even to insignificant penetration of pathogenic microflora into the body, which often becomes the cause of the development of serious pathological processes in the body.

For example, renal pathologies can lead to such a delicate problem as nocturia. Symptoms of such a condition in women may well proceed without pain, but they are accompanied by poor health or a variety of secretions. Nocturia can manifest itself in women:

  • The development of cystitis in women is accompanied by frequent urination to urinate, in advanced cases even urinary incontinence, severe cutting pains, day and night pains when the bladder is full.
  • The presence of urolithiasis in the urethral system. Frequent visits to the toilet, minimal stress, walking or sudden movements cause acute painful symptoms in the groin. A characteristic feature of the pathological process is a feeling of not completely urinating after the procedure and even in its process.
  • Symptoms of nocturia are clearly manifested in chronic pyelonephritis , accompanied by high fever and dull pain in the lumbar area.
  • The symptomatology of the nocturia of cardiovascular genesis is expressed in women by edema tissue.

With the development of renal or cardiac nocturia, frequent nocturnal trips to the toilet can become permanently chronic, which will adversely affect the further treatment of nocturia.

Nocturia treatment - drugs and techniques

Nocturia treatment

Methods of treating nocturia in women, as in men, are aimed at identifying and stopping the background processes that caused the pathology. When pathologies of cardiac and vascular genesis are detected, a cardiologist is involved in the treatment.

After performing the necessary diagnostic studies, appropriate, individually selected treatment is assigned, aimed at stopping major hemodynamic changes.

If organic cardiac or vascular disorders are detected, recommendations for surgical treatment are possible.

X-ray endovascular intervention may be required when atherosclerosis is found in the renal arteries. This minimally invasive surgical method restores vascular permeability and restoration of blood flow.

At the same time, access to the affected area of ​​the vessel is carried out by means of a puncture, through the femoral vessel, which does not leave behind a large surgical incision.

When treating nocturia in men with adenomatous lesions of the prostate, surgical intervention may be required. Today, there are many modern methods to eliminate tumor neoplasms in the prostate.

Access to the surgical field through the urethra. Such techniques are characterized by a productive effect, allowing treatment in a short period of time.

As a pharmacological individual treatment of nicturia, drugs are prescribed:

  • Drugs to improve blood circulation - "Pentoxifylline" and its analogues;
  • Nootropic drugs - "Piracetam" and others.
  • NVPS - Diclofenac, Ibuprofen, Indomethacin;
  • Antidepressants - Sertralin, Tianeptin, Fluoxetine, Citalopram;
  • Preparations improving the function of the urethral canal and bladder - “Oxybutynin”, “Tolterodin”, “Solifenacin”;
  • In case of atrophy of the lower parts of the urethra, and pathologies of the bladder - individual doses of "Ovestin".

Patients are recommended to keep a urination diary. According to his data, according to the vaginal state, urodynamic and colposcopic examination, an assessment of the dynamics of clinical symptoms after three and six months is carried out.


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