Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York.
Department of Neurology, Emory University School of Medicine, Atlanta, Georgia.
Neurourol Urodyn. 2020 Nov;39(8):2301-2304. doi: 10.1002/nau.24485. Epub 2020 Aug 18.
The relationship between maximum voided volumes (MVV) during the night and day is poorly understood. Such measurements are important because they are often used to indicate functional bladder capacity (FBC), a relevant parameter for nocturia. This study examined the association of such nighttime and daytime measurements in men with nocturia.
We retrospectively analyzed 356 24-hour voiding diaries showing ≥2 nocturnal voids from 220 men at an outpatient urology clinic. We defined small FBC as MVV ≤ 200 mL.
A total of 131 entries demonstrated a nocturnal MVV ≤ 200 mL, of which a majority (98 [74.8%]) also showed a 24-hour MVV ≤ 200 mL (ie, global small FBC), and 33 (25.2%) exceeded the 200 mL threshold during the day (ie, nocturnal-specific small FBC). Correspondingly, among voiding diaries without global small FBC (n = 258), most (225/258 [87.2%]) showed a nocturnal MVV > 200 mL. Data were similar when analyzing only the first complete voiding diary per case, when limiting analyses to those without benign prostatic obstruction, and when limiting analyses to cases with nocturnal polyuria.
Nocturia may be attributable to nocturnal-specific small FBC or global small FBC. Although the etiology of nocturnal-specific small FBC remains unclear, it was present in a significant minority of patients with small FBC, thus necessitating more directed research. Conversely, diminished nocturnal MVV was nevertheless relatively uncommon in the absence of global small FBC, such that nocturnal-only voiding diaries may provide a rational alternative for follow-up evaluation in patients with nocturia due to global small bladder capacity.
夜间和白天最大排尿量(MVV)之间的关系尚未得到充分理解。这些测量很重要,因为它们通常用于表示功能性膀胱容量(FBC),这是夜尿症的一个相关参数。本研究检查了男性夜尿症与这些夜间和日间测量值之间的关联。
我们回顾性分析了 220 名门诊泌尿科就诊患者的 356 份 24 小时排尿日记,这些日记显示有≥2 次夜间排尿。我们将小 FBC 定义为 MVV≤200ml。
共有 131 项记录显示夜间 MVV≤200ml,其中大多数(98[74.8%])还显示 24 小时 MVV≤200ml(即全球小 FBC),33 项(25.2%)白天超过 200ml 阈值(即夜间特异性小 FBC)。相应地,在没有全球小 FBC 的排尿日记中(n=258),大多数(225/258[87.2%])显示夜间 MVV>200ml。当仅分析每个病例的第一个完整排尿日记、当将分析限于没有良性前列腺增生的病例以及当将分析限于有夜间多尿的病例时,数据相似。
夜尿症可能归因于夜间特异性小 FBC 或全球小 FBC。尽管夜间特异性小 FBC 的病因尚不清楚,但在小 FBC 患者中仍有相当一部分存在,因此需要更有针对性的研究。相反,在没有全球小 FBC 的情况下,夜间 MVV 减少仍然相对罕见,因此在由于全球小膀胱容量导致夜尿症的患者中,仅夜间排尿日记可能是随访评估的合理替代方法。