The predominance of night diuresis above day-time, urology has called nocturia. A pathological condition characterized by disorder of urination during the day as a result of diseases of the urinary and cardiovascular systems. The percentage breakdown of the night urination in older men occurs two times more often than women.
One of the reasons Victoriei is a hormonal disorder. An imbalance in the regulation of electrolyte balance caused by excessive action of antidiuretic hormone on the absorption of fluids in the renal glomeruli. The hormone provides reduced excretory function of paired organs and reduces the secretion of uric acid.
As a result of violations of production of antidiuretic hormone is a violation of the regulation of the water levels in the body.
The causes of nocturia, depending on comorbidities:
- Diabetes insipidus. Accompanied by insignificant changes of blood flow in the renal system. The increase in nocturnal urine associated with the use of large amounts of water as a result of severe thirst.
- Nephrosclerosis, glomerulonephritis in acute and chronic form. The disease develops in lesions and inflammation of the renal coil.
- Hypertension. During a night’s sleep there is a reduction of the tone of renal vessels.
- Atherosclerosis of renal vessels. Occurs mainly in the elderly, when there is insufficient blood supply to the renal coil.
- Cardiovascular disease. Disorder of blood supply to the kidneys.
- Endocrine disorders. Occurs an inadequate increase in the concentration of antidiuretic hormone in relation to plasma.
- Hypokalemia. Reduced sensitivity of the renal tubules.
The increase in nocturnal urine can be a symptom of serious diseases of the cardiovascular and endocrine systems
To increased nocturnal urine polyuria does not apply, since the urination becomes more frequent in the daytime.
Factors contributing to the breakdown of the nocturnal urine:
- The reception in the evening a large number of fluids with a diuretic effect (green tea, beer, broth hips).
- Pregnancy (in the last period, the uterus exerts strong pressure on the bladder).
- Infectious disease stage of chronic process (tuberculosis, syphilis, malaria).
The norm to take regarding the increase in the ratio of allocation of urine at night nocturia in children under 2 years, a feature associated with a functional characteristic of the excretory system in children.
Nocturia is the first signal in heart failure
Heart failure is characterized by the breakdown of the night urination as a result of decrease blood supply to the kidneys during the day.
The mechanism of development of nocturia in heart failure due to a decrease in cardiac output, which is distributed primarily in hard working muscles, organs and tissues. The lack of physical activity in nighttime and horizontal position of the body, reduces contractile activity of the myocardium, which is manifested in the reduction of blood supply to the kidneys and increase the evacuation of fluid from the tissues.
This process restores the water-salt balance in the body, and a fully kompensiruet daytime oliguria. With the progression of heart failure the rest of the myocardium at night sufficient to restore blood flow to the kidneys, a lack of nocturnal urine causes persistent swelling.
Classification of nocturia
The clinical picture of nocturia there are several stages of the pathological process:
- Difficult urination, absence of residual urine.
- Shortness of urination, residual urine.
- Difficult urination, residual urine increases in volume, develop chronic urinary retention, overflow urinary bladder.
Symptoms of the disease
About nocturia is usually considered as the condition when the amount of urination at night is more than 3 times.
The severity of symptoms of nocturia depends on the disease that triggered its development.
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Common signs of increasing the nocturnal urine:
- thirst, even in cold weather;
- pollakiuria (frequent urination);
- feeling of incomplete emptying of the bladder;
- urine comes out in a thin stream;
- pain of the lumbar;
- swelling of the face and feet;
- changes in body weight throughout the day.
Symptoms from the urinary system caused by inflammatory process in the urinary bladder and the nephrons of the kidney. The symptoms and treatment of night-connected disorder, since treatment of the disease it is necessary to know the characteristic symptoms of co-morbidities.
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The clinical picture of nocturia cystitis:
- pain in the lower abdomen;
- pain during the urination;
- the increase in body temperature.
Pyelonephritis nicturia accompany the following symptoms:
- nausea, vomiting;
- subfebrile body temperature;
- excessive sweating;
- shooting pains in the lower back;
- abdominal pain;
The clinical picture of the night’s disorders in hydronephrosis:
- constant feeling of thirst;
- intoxication syndrome;
- pain in the abdomen;
- increase in blood pressure;
- increasing swelling.
The increase in nocturnal urine can be a manifestation of the side effects of drugs, especially diuretics.
Symptoms of the disease after the overdose of drugs:
- urination disorder;
- night urine contains fresh red blood cells;
- loss of appetite;
- swelling of the legs;
- fluctuations of body weight;
- skin rash.
Features of nocturia in women
Genito-urinary system women are very sensitive, it responds instantly to the penetration of pathogenic microorganisms that cause the development of inflammatory processes.
Nocturia in women may occur after diseases of the urinary system, which can proceed smoothly, only worsening the General condition of the body.
The increase of night urine output can occur after the following diseases:
- Cystitis. The inflammatory process affects the mucous membrane of the bladder, resulting in urination disorder, there is an increasing need to visit the toilet. Overfilling of the bladder is accompanied by cutting pains, and nocturnal incontinence.
- Urolithiasis. The presence of stones in the lumen of the urethra could lead to urinate, especially at night, pain during movement, the sense of incompleteness of the process after going to the toilet.
Violation of concentration function of the kidney in women is manifested in the increase in the density of urine, night urine as concentrations below the daily.
Features of nocturia in men
More frequent urination in men occur in the elderly due to age-related changes of the cumulative function of the bladder.
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Nocturia in men can provoke the following diseases:
- Overactive bladder. Admission into the bladder even small amounts of urine, causing an urge to urinate. Pathology may be an independent disease or concomitant symptom of benign prostatic hyperplasia.
- Prostate adenoma. Causes the appearance of disorders of the night to urinate. The prostate increases in size, leading to compression of the urethra and circulatory disorder in the bladder.
At the first signs of urination disorders need to consult a specialist to determine the cause of the changes. After the collection of medical history and complaints of the patient, the doctor prescribes the basic and advanced research methods to clarify the cause of the condition.
Urine analysis according to Nechyporenko will help to assess the functional state of the urinary system
List the main methods of research:
- Digital rectal examination of the prostate.
- General blood analysis (determination of the physico-chemical characteristics of urine).
- Urine culture for bacterial flora.
- Test for Nechiporenko.
- Biochemical analysis of blood (urea, creatinine, creatinine clearance, test of Rehberg).
- Determination of the residual urine.
- Ultrasound diagnosis of the urinary system.
- Excretory radiography.
Instrumental methods of investigation:
To determine the extent of the disease, the patient is encouraged to keep a diary in which to record the amount of urination for three days.
Treatment of nocturia is directed at eliminating the underlying disease that caused the disease and relief of concomitant symptoms.
At the first symptoms of the disorder nocturnal urine you need to consult a urologist to determine the cause and selection of effective treatment method
For a comprehensive treatment of night disorders prescribed the following drugs.
Antibacterial therapy. The elimination of the inflammatory process in the bladder (Monural, Citral, Nolicin).
Sulfa therapy. In the event of pyelonephritis (Resultan, Sulfadimezin, Etazol).
Cardiac glycosides. Heart failure (Strophanthin, Digoxin).
To treat nycturia in men with prostate cancer, the only possible operational method.
Folk remedy to combat the disease
Treatment of folk remedies is using herbs and plants used to prepare infusions, decoctions and tinctures.
Urology treatment of folk remedies is used in combination with drug therapy
Recipes alternative medicine for the treatment of nocturia:
- Freshly squeezed pumpkin juice. Daily use helps to combat age-related changes of the prostate in men.
- Based on the infusion of birch leaves will also help to prevent abnormal growth of the prostate gland. For infusion you need: 2 tbsp. l. chopped birch leaves pour 1 Cup boiling water, then infuse for 2-3 hours. Take 0.5 cups for months.
- Milk with parsley. Helps in inflammatory processes in the kidneys. Preparation: 4 tbsp fresh parsley leaves, pour 500 ml of hot milk, keep on a water bath to reduce the amount of liquid by 2 times.
- Based on the infusion of leaves of plantain. Preparation:1 tbsp. l. dry leaves of plantain pour 1 Cup of boiling water for 60 minutes at room temperature. Take half a Cup a day for an overactive bladder.
To prevent diseases it is necessary to limit the amount of fluid you drink before bedtime, eliminate bad habits and to avoid excessive physical exertion in the pathology of the heart.