Department of Urology, University Hospital Maastricht, Maastricht, The Netherlands.
Curr Opin Obstet Gynecol. 2011 Oct;23(5):376-85. doi: 10.1097/GCO.0b013e32834ac78c.
Nocturia is a bothersome and highly prevalent condition characterized by the need to wake to void at night. Nocturia is equally common in men and women, and although its prevalence increases with age, a significant proportion of younger people are also affected. Nocturia leads to fragmentation of sleep and consequently to a serious decline in daytime functioning and in quality of life and health. Its impact should not be underestimated by clinicians and therefore a review on nocturia is timely and relevant.
Traditionally, nocturia is regarded as a symptom of benign prostatic enlargement and/or overactive bladder syndrome, with treatment therefore directed toward increasing the capacity of the bladder to hold urine. Such treatments have proven ineffective in many patients because nocturnal polyuria, an overproduction of urine at night, has been found to be present in the majority of patients. Nocturia can be attributed to some underlying pathological factors but it can also be a distinct clinical entity with specific pathogenesis. Frequency-volume charts are recommended for routine use in clinical practice, to determine whether nocturia is a result of excessive urine production at night, or of small voided volumes due to bladder problems, or a combination of these factors. Desmopressin, a synthetic analogue of the antidiuretic hormone, should be considered in patients with nocturia where nocturnal polyuria is present.
Contrary to popular and medical misconception nocturia is an important condition leading to general morbidity and with serious impact on overall quality of life and health. We advise clinicians to pay attention to nocturia and diagnostics should be offered. Treatment modalities are available and have to be discussed with the patient.
夜尿症是一种令人困扰且普遍存在的病症,其特征是夜间需要醒来排尿。男性和女性的夜尿症患病率相当,尽管其患病率随着年龄的增长而增加,但仍有相当一部分年轻人受到影响。夜尿症会导致睡眠碎片化,进而严重影响白天的功能以及生活质量和健康。临床医生不应低估其影响,因此及时对夜尿症进行综述是非常必要的。
传统上,夜尿症被认为是良性前列腺增生和/或膀胱过度活动症的症状,因此治疗方法旨在增加膀胱的储尿能力。但这些治疗方法在许多患者中被证明无效,因为大多数患者都存在夜间多尿,即夜间尿液过度产生。夜尿症可能归因于某些潜在的病理因素,但它也可能是一种具有特定发病机制的独特临床实体。推荐在临床实践中常规使用频率-容量图表,以确定夜尿症是由于夜间过量产尿,还是由于膀胱问题导致每次排尿量较小,还是这两个因素的结合。如果存在夜间多尿,应考虑使用去氨加压素,这是一种抗利尿激素的合成类似物。
与普遍存在的误解和医学误区相反,夜尿症是一种重要的病症,会导致普遍发病,对整体生活质量和健康产生严重影响。我们建议临床医生关注夜尿症,并提供相关诊断。现已有多种治疗方法可供选择,需要与患者讨论。