The Etiologic Classification of Nocturia among 133 Thai Patients in a Tertiary Teaching Hospital

Supanat Sirikulchayanonta, Sompol Permpongkosol

Division of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

DOI: 10.4236/oju.2013.31006                

Abstract

Introduction: Nocturia is categorized into many categories. Each category requires different approaches and treatment. We aimed to obtain data regarding nocturia, classified into categories according to its pathogenesis, in Thai patients. Methods: We reviewed 133 medical records and voiding diaries of the patients who attended a urologic clinic in a tertiary teaching hospital during year 2009-2010 with nocturia problems. Those data were analyzed to sort these nocturia patients into the appropriate categories. Results: There were a total of 133 patients, consisting of 94 males (70.1%) and 39 females (29.9%). Overall mean age was 64.74 ± 25.85 years. There was no statistically difference between the two genders (Male 65.94 ± 24.56 years vs. Female 61.87 ± 28.24 years, p = 0.10). Among these, 71 patients (53.4%) had nocturnal polyuria. Almost all patients (132 patients, 99.2%) met the criteria for diminished global/nocturnal bladder capacity. The younger patients (less than 40 years) were found to have more severe clinical symptoms than the older patients (6 from 8 or 75% vs. 46 from 125 or 36%, p = 0.032). Seventy patients (52.6%) met the criteria of Mixed NP and Diminished. There were 32 patients (24.1%) found in the group of Global polyuria. Only one patient was classified as isolated nocturnal polyuria and none as isolated global polyuria. Conclusion: Nocturnal polyuria and global polyuria are not uncommon conditions and most of these patients might have concomitant diminished bladder capacity for which investigation or simultaneous treatment may be needed to gain the best treatment result.

Keywords

Nocturia; Prevalence; Etiology; Classification; Sleep Disorders

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	P. Abrams, C. Chapple, et al., “Evaluation and Treatment of Lower Urinary Tract Symptoms in Older Men,” The Journal of Urology, Vol. 181, No. 4, 2009, pp. 1779-1787. doi:10.1016/j.juro.2008.11.127
[2]	R. Asplund and H. Aberg, “Diurnal Variation in the Levels of Antidiuretic Hormone in the Elderly,” Journal of Internal Medicine, Vol. 229, No. 2, 1991, pp. 131-134. doi:10.1111/j.1365-2796.1991.tb00320.x
[3]	M. H. Blanker, A. M. Bohnen, et al., “Normal Voiding Patterns and Determinants of Increased Diurnal and Nocturnal Voiding Frequency in Elderly Men,” The Journal of Urology, Vol. 164, No. 4, 2000, pp. 1201-1205. doi:10.1016/S0022-5347(05)67141-8
[4]	K. L. Burgio, T. M. Johnson II, et al., “Prevalence and Correlates of Nocturia in Community-Dwelling Older Adults,” Journal of the American Geriatrics Society, Vol. 58, No. 5, 2010, pp. 861-866. doi:10.1111/j.1532-5415.2010.02822.x
[5]	F. Y. Chen, Y. T. Dai, et al., “Perception of Nocturia and Medical Consulting Behavior among Community-Dwelling Women,” International Urogynecology Journal and Pelvic Floor Dysfunction, Vol. 18, No. 4, 2007, pp. 431-436. doi:10.1007/s00192-006-0167-x
[6]	M. S. Choo, J. H. Ku, et al., “Prevalence of Nocturia in a Korean Population Aged 40 to 89 Years,” Neurourology and Urodynamics, Vol. 27, No. 1, 2008, pp. 60-64. doi:10.1002/nau.20458
[7]	C. G. Chute, L. A. Panser, et al., “The Prevalence of Prostatism: A Population-Based Survey of Urinary Symptoms,” The Journal of Urology, Vol. 150, No. 1, 1993, pp. 85-89.
[8]	K. S. Coyne, Z. Zhou, et al., “The Prevalence of Nocturia and Its Effect on Health-Related Quality of Life and Sleep in a Community Sample in the USA,” BJU International, Vol. 92, No. 9, 2003, pp. 948-954. doi:10.1111/j.1464-410X.2003.04527.x
[9]	C. E. DuBeau, S. V. Yalla, et al., “Implications of the Most Bothersome Prostatism Symptom for Clinical Care and Outcomes Research,” Journal of the American Geriatrics Society, Vol. 43, No. 9, 1995, pp. 985-992.
[10]	D. J. Foley, M. V. Vitiello, et al., “Frequent Napping Is Associated with Excessive Daytime Sleepiness, Depression, Pain, and Nocturia in Older Adults: Findings from the National Sleep Foundation ‘2003 Sleep in America’ Poll,” The American Journal of Geriatric Psychiatry: Official Journal of the American Association for Geriatric Psychiatry, Vol. 15, No. 4, 2007, pp. 344-350.
[11]	D. M. Gulur, A. M. Mevcha, et al., “Nocturia as a Manifestation of Systemic Disease,” BJU International, Vol. 107, No. 5, 2011, pp. 702-713. doi:10.1111/j.1464-410X.2010.09763.x
[12]	C. H. Hsieh, H. Y. Chen, et al., “Prevalence of Nocturia in Taiwanese Women Aged 20 - 59 Years,” Taiwanese Journal of Obstetrics & Gynecology, Vol. 46, No. 1, 2007, pp. 50-53. doi:10.1016/S1028-4559(08)60107-2
[13]	U. G. Malmsten, I. Milsom, et al., “Urinary Incontinence and Lower Urinary Tract Symptoms: An Epidemiological Study of Men Aged 45 to 99 Years,” The Journal of Urology, Vol. 158, No. 5, 1997, pp. 1733-1737. doi:10.1016/S0022-5347(01)64113-2
[14]	A. D. Markland, C. P. Vaughan, et al., “Prevalence of nocturia in United States Men: Results from the National Health and Nutrition Examination Survey,” The Journal of Urology, Vol. 185, No. 3, 2011, pp. 998-1002. doi:10.1016/j.juro.2010.10.083
[15]	H. A. Middelkoop, D. A. Smilde-van den Doel, et al., “Subjective Sleep Characteristics of 1485 Males and Females Aged 50 - 93: Effects of Sex and Age, and Factors Related to Self-Evaluated Quality of Sleep,” The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, Vol. 51, No. 3, 1996, pp. M108-M115. doi:10.1093/gerona/51A.3.M108
[16]	J. K. Parsons, J. Mougey, et al., “Lower Urinary Tract Symptoms Increase the Risk of Falls in Older Men,” BJU International, Vol. 104, No. 1, 2009, pp. 63-68. doi:10.1111/j.1464-410X.2008.08317.x
[17]	K. T. C. H. Hsieh, C. S. Hsu, S. T. Chang and M. C. Lee, “Nocturia among Women Aged 60 or Older in Taiwan,” Australian and New Zealand Journal of Obstetrics and Gynaecology, Vol. 48, No. 3, 2008, pp. 312-316. doi:10.1111/j.1479-828X.2008.00870.x
[18]	S. Hunskaar, “Epidemiology of Nocturia,” BJU International, Vol. 96, Supplement 1, 2005, pp. 4-7. doi:10.1111/j.1464-410X.2005.05650.x
[19]	V. Kupelian, R. C. Rosen, et al., “Association of Urological Symptoms and Chronic Illness in Men and Women: Contributions of Symptom Severity and Duration—Results from the BACH Survey,” The Journal of Urology Vol. 181, No. 2, 2009, pp. 694-700. doi:10.1016/j.juro.2008.10.039
[20]	G. Schatzl, C. Temml, et al., “Cross-Sectional Study of Nocturia in Both Sexes: Analysis of a Voluntary Health Screening Project,” Urology, Vol. 56, No. 1, 2000, pp. 71-75. doi:10.1016/S0090-4295(00)00603-8
[21]	L. V. Swithinbank, S. T. Brookes, et al., “The Natural History of Urinary Symptoms during Adolescence,” British Journal of Urology, Vol. 81 Supplement 3, 1998, pp. 90-93. doi:10.1046/j.1464-410x.1998.00016.x
[22]	K. A. Tikkinen, A. Auvinen, et al., “A systematic Evaluation of Factors Associated with Nocturia—The Population-Based FINNO Study,” American Journal of Epidemiology Vol. 170, No. 3, 2009, pp. 361-368. doi:10.1093/aje/kwp133
[23]	L. van Dijk, D. G. Kooij, et al., “Nocturia in the Dutch Adult Population,” BJU International, Vol. 90, No. 7, 2002, pp. 644-648. doi:10.1046/j.1464-410X.2002.03011.x
[24]	P. van Kerrebroeck, P. Abrams, et al., “The Standardisation of Terminology in Nocturia: Report from the Standardisation Sub-Committee of the International Continence Society,” Neurourology and Urodynamics, Vol. 21, No. 2, 2002, pp. 179-183. doi:10.1002/nau.10053
[25]	J. P. Weiss, J. G. Blaivas, et al., “Nocturia in Adults: Etiology and Classification,” Neurourology and Urodynamics, Vol. 17, No. 5, 1998, pp. 467-472. doi:10.1002/(SICI)1520-6777(1998)17:5<467::AID-NAU2>3.0.CO;2-B
[26]	J. P. Weiss, A. J. Wein, et al., “Nocturia: New Directions,” Neurourology and Urodynamics, Vol. 30, No. 5, 2011, pp. 700-703. doi:10.1002/nau.21125
[27]	J. P. Weiss, A. C. Weinberg, et al., “New Aspects of the Classification of Nocturia,” Current Urology Reports, Vol. 9, No. 5, 2008, pp. 362-367. doi:10.1007/s11934-008-0063-7
[28]	K. Yoshimura, N. Terada, et al., “Prevalence of and Risk Factors for Nocturia: Analysis of a Health Screening Program,” International Journal of Urology: Official Journal of the Japanese Urological Association, Vol. 11, No. 5, 2004, pp. 282-287. doi:10.1111/j.1442-2042.2004.00791.x