Nocturia - what is this? Treatment, signs, causes in women and men

Nicturia - what is it?

A healthy adult body releases up to 80% of the urine of the total amount of liquid consumed per day. The ratio of the amount of urine released during the day and night varies by almost a third - 2/3-day and 1/3-night. When the ratio changes, and the nighttime urination exceeds the daily rate - this is nocturia.

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

Causes of nocturia - general and night form of

Causative factors of nocturia are due to hormonal imbalance and problems associated with functionalstate in the structure of the bladder. Regulation of water balance in our body is carried out by two hormones - vasopressin( antidiuretic hormone) "WUA", produced by the posterior lobe of the pituitary gland and by the atrial natriuretic( "ANG") hormone.

The action of the hormone "WUA" is caused by the increased absorption of the fluid in the renal glomerular system, thereby reducing the excretory functions of the kidneys and lowering the secretion of uric acid. This hormone performs the functions of regulating the level of water saturation of the body.

But when, in cardiac conditions, saturation of cardiac muscle tissue with blood occurs, the release of natriuretic hormones occurs. With the activation of these hormones, there are processes of water release and increased secretion of urine. The causes of nocturia night are due to four fundamental factors:

1. General polyuria, when the increase in urine released per day depends on a number of clinical signs of renal and neuromuscular endocrine disorders.
2. Night polyuria caused by increased urine output at night.
3. Disorders in the bladder, depriving him of the ability to hold urine.

General and night polyuria develop as a result of an imbalance in the level of hormones "WUA", or "ANG".The third point is due to pathological processes in the bladder.

This can be explained in simple language with simple examples. With nocturia cardiac, patients in the daytime increase heart and fluid intake, which contributes to stagnant processes of blood and water in the tissue structures.

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

With nocturia renal, caused by renal pathologies, at night blood flow improves in the affected renal tissues, its movement along the kidney vessels is accelerated. The development of hypertensive diuresis, which increases the excretion of urine up to twelve times, begins.

Disorders in the ratio of urine output in the daytime and at night is considered a functional norm only with nocturia in children, and then, only up to 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.

Symptoms of nocturia in men

The violation of quantitative ratios of urine excretion towards increased visits to the toilet at night, in men is manifested( in most cases) in adulthood. It develops at the beginning of signs of quantitative equalization of urination during the day and night visits to the toilet at night.

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

This condition can be caused by a number of pathological causes:

• by the incompetence of the heart muscles to pump a sufficient amount of blood and to ensure in due measure the processes of tissue metabolism, provoking stagnant processes and puffiness;
• by violation of blood flow through the vessels, which feed the heart muscle with atherosclerotic formations( plaques);
• is a consequence of sleep apnea syndrome;
• with kidney diseases;
• deficiency of steroid hormones;
• 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 bladder cavity, provoked by: fibrotic and malignant neoplasms, the use of therapeutic methods of ionized radiation, pathological processes in the lower zones of the urethra, and obstructions in the neck of the bladder.

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

Emaciating symptoms are manifested:

• with a prolonged delay immediately before the act of urination;
• a thin trickle of urine output;
• "terminal" stage of emptying - drip yield of urine;
• by involuntary yield of urine drop by drop, after the urinary process;
• sensation is not the full yield of urine.

Cumulative symptoms are characterized by:

• rapid urination;
• by increasing trips to the toilet at night;
• imperative urges( failure of a long delay of urination);
• by imperative urinary incontinence( inability to control, urination often occurs without reaching the toilet).

Symptoms of nocturia in women

Women have a more sensitive genitourinary system, which reacts sharply even to insignificant penetration of the pathogenic microflora into the body, which often leads to the development of serious pathological processes in the body.

For example, kidney pathologies can lead to such a delicate problem as nocturia. Symptoms of this condition in women may well occur without pain, but accompanied by poor health or various kinds of secretions. Manifestation of nocturia in women can:

• The development of the processes of cystitis in women is accompanied by frequent urge to urinate, in neglected cases, even incontinence, severe cutting pains, day and night pains with a filled bladder.
• The presence of urolithiasis in the urethral system. Frequent trips to the toilet, minimal loads, walking or sudden movements cause acute painful symptoms in the groin. A characteristic sign of the pathological process is the feeling of not complete urination after the procedure and even in its process.
• Signs of nocturia are clearly manifested in chronic pyelonephritis, accompanied by high fever and blunt pain in the lumbar region.
• The symptomatology of nocturia of cardiovascular genesis is expressed in women by edematous tissue.

With the development of renal or cardiac nocturia, frequent night trips to the toilet can assume a permanent chronic character, which will negatively affect the further treatment of nocturia.

Treatment of nocturia - drugs and techniques

Methods for treating nocturia in women, as well as in men, are aimed at identifying and arresting background processes that caused pathology. When a pathology of cardiac and vascular genesis is detected, a cardiologist is connected to treatment.

After performing the necessary diagnostic tests, an appropriate, individually selected treatment is prescribed, aimed at arresting the major hemodynamic changes.

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

X-ray endovascular intervention may be required if atherosclerosis is detected in the renal arteries. This minimally invasive surgical method restores vascular patency and restores blood flow.

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

In the treatment of nocturia in men with the detection of adenomatous lesion of the prostate, surgical intervention may be required. Today, there are many modern techniques for eliminating tumoral neoplasms in the prostate.

Access to the operating theater is via the urethra. Such techniques are characterized by the effective effect, allowing to conduct treatment in a short period of time.

As a pharmacological individual treatment for nocturia, drugs are prescribed:

• Drugs for improving blood circulation - Pentoxifylline and its analogs;
• Nootropics - "Piracetam", etc.
• NVPS - "Diclofenac", "Ibuprofen", "Indomethacin";
• Antidepressants - Sertraline, Tianeptine, Fluoxetine, Citalopram;
• Drugs that improve the function of the urethral canal and bladder - "Oxibutinin", "Tolterodin", "Solifenacin";
• When atrophy of the lower sections of the urethra, and bladder pathologies - individual doses of "Ovestina".

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