A Simple Guide To Nocturia, (Excessive Night Urination) Diagnosis, Treatment And Related Conditions

A

Simple

Guide

To

Nocturia,

(Excessive Night Urination)

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2021 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Nocturia (Excessive Night Urination), Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Nocturia)

This e-Book is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiography account of my journey as a medical student to family doctor on my other blog: http://afamilydoctorstale.blogspot.com.

This autobiography account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

My diagnosis and treatment capability has improved tremendously from my continued education.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Nocturia

What is Nocturia?

Nocturia or nocturnal polyuria is the medical term for the symptom of excessive urination at night.

During sleep time, the body produces less urine that is more concentrated.

This indicates that most people do not need to wake up during the night to urinate and can sleep uninterrupted for 6 to 8 hours.

If the patient needs to wake up 2 times or more per night to urinate, the patient may have nocturia.

A period of sleep must happen before and follow the urinary event to count as a nocturia episode.

This indicates the first-morning void is not regarded as a nocturia episode.

Nocturnal frequency is the same as nocturia except that in nocturia the voiding episodes each occurred and followed by sleep periods.

Besides being disruptive to the sleep, nocturia can also be a sign of an underlying medical disorder.

Nocturia is the passage of greater urine output during the night, waking the patient up from sleep.

The urine output equals more than 20% of the daily total in younger persons and more than 33% in elderly persons.

It is important to keep in mind that persons with nocturnal polyuria syndrome have normal 24 hour urinary output not exceeding 40 ml/kg body weight.

A measurement devised to standardize the medical diagnosis of nocturnal polyuria syndrome is the

nocturnal polyuria index (NPi) i.e. the nocturnal urine amount produced as a percentage of the 24-hour urine output.

Persons with NPi higher than 35 percent are said to have nocturnal polyuria.

It is one of the underlying causes of nocturia, which is defined as the greater passage of urine during night, waking the patient up from sleep.

Nocturia is a disorder that causes the patient to wake up during the night to urinate.

This can be thought of as nocturnal urinary frequency having to urinate more often at night.

This disorder becomes more frequent as people age and happens in both men and women, occasionally for different reasons.

It can be frequent for most people to wake up once during the night to urinate, but urinating more often may be a sign of something else going on.

Nocturia can be linked with daytime urinary frequency or happen by itself.

It is important to differentiate nocturia (urinating too frequently) from polyuria (urinating too much volume).

Nocturia has a total of 4 major underlying causes -

1. Global polyuria

Urine output rises throughout the day, and the total 24 hour urine output surpasses 40 ml/kg body weight.

2. Nocturnal polyuria

Urine output rises at night with proportional reduction in daytime urine output.

The total 24 hour urine output hence stays normal.

3. Bladder storage disorders that decrease the bladder capacity enlarged prostate

a. Neurogenic bladder

b. Drugs,

c. Anxiety, stress, restlessness

4. Mixed causes-hormonal and bladder disorders

The first two disorders are linked with abnormal levels of arginine vasopressin (AVP) or atrial natriuretic hormone (ANH).

The third disorder is a bladder disorder.

Incidence of Nocturia

Statistics show that 5-15% of people between 20-50 years, 20-30% of people between 50–70 years, and 10-50% of people older than 70 years old urinate at least twice a night.

Nocturia increases with age.

The incidence increases in people above the age of 80 years.

More than 50 % of men and women over the age of 60 years have been diagnosed to have nocturia in many populations.

Nocturia happens equally among both sexes, but the incidence is higher in younger women compared to younger men and in older