Monaghan Thomas F, Kavoussi Adriana M, Agudelo Christina W, Rahman Syed N, Michelson Kyle P, Bliwise Donald L, Lazar Jason M, Birder Lori A, Alwis Upeksha S, Walle Johan Vande, Wein Alan J, Blaivas Jerry G, Weiss Jeffrey P, Everaert Karel
Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA.
Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
Int Neurourol J. 2020 Sep;24(3):270-277. doi: 10.5213/inj.2040166.083. Epub 2020 Sep 30.
Low nocturnal urine production (NUP) may be sufficient to rule out global polyuria (GP) in men. This study determines the sensitivity of indices for nocturnal polyuria (NP), defined as nocturnal polyuria index (NPi; nocturnal urine volume/24-hour urine volume) ≥0.33 or NUP ≥90 mL/hr, for detecting GP in women.
Data were analyzed from 2 prospective protocols involving subjects recruited from a urology ambulatory care unit and a continence clinic. Women ≥18 years with nocturia were included if they met either of 2 common criteria for GP: (1) ≥40 mL/kg/24 hr or (2) ≥3,000 mL/24 hr.
Thirty-one women were included (NPi, 28.6 [21.3-40.7]; NUP, 100.8 [68.3-135.8] mL/hr). At the ≥40 mL/kg/24-hr cutoff, 40% and 63% of women reporting ≥1 nocturnal void(s) (n=30) had NPi ≥0.33 and NUP ≥90 mL/hr, respectively. Additionally, 53% and 71% of subjects reporting ≥2 nocturnal voids (n=17) had NPi ≥0.33 and NUP ≥90 mL/hr, respectively. At the ≥3,000 mL/24-hr cutoff, 38% and 69% of women reporting ≥1 nocturnal void(s) (n=13) had NPi ≥0.33 and NUP ≥90 mL/hr, respectively, and 63% and 88% of subjects reporting ≥2 nocturnal voids (n=8) had NPi ≥0.33 and NUP ≥90 mL/hr, respectively. By extension, 37%-62% of women with nocturia and GP did not have NP by NPi ≥0.33 criteria, and 12%-37% did not have NP by NUP ≥90 mL/hr criteria.
Indices of excess nighttime urination do not reliably predict GP in women. A full-length voiding diary may be particularly important in the evaluation of women with nocturia. Nocturia in women merits further consideration as a distinct entity.
低夜间尿量(NUP)可能足以排除男性的全身性多尿(GP)。本研究确定夜间多尿(NP)指标,即夜间多尿指数(NPi;夜间尿量/24小时尿量)≥0.33或NUP≥90 mL/小时,用于检测女性GP的敏感性。
分析了来自2项前瞻性方案的数据,这些方案涉及从泌尿外科门诊护理单元和尿失禁诊所招募的受试者。年龄≥18岁且有夜尿症的女性,如果符合GP的2项常见标准之一则纳入研究:(1)≥40 mL/(kg·24小时)或(2)≥3000 mL/24小时。
纳入31名女性(NPi,28.6[21.3 - 40.7];NUP,100.8[68.3 - 135.8]mL/小时)。在≥40 mL/(kg·24小时)的截断值下,报告有≥1次夜间排尿(n = 30)的女性中,分别有40%和63%的NPi≥0.33和NUP≥90 mL/小时。此外,报告有≥2次夜间排尿(n = 17)的受试者中,分别有53%和71%的NPi≥0.33和NUP≥90 mL/小时。在≥3000 mL/24小时的截断值下,报告有≥1次夜间排尿(n = 13)的女性中,分别有38%和69%的NPi≥0.33和NUP≥90 mL/小时,报告有≥2次夜间排尿(n = 8)的受试者中,分别有63%和88%的NPi≥0.33和NUP≥90 mL/小时。由此推断,37% - 62%有夜尿症和GP的女性不符合NPi≥0.33标准的NP诊断,12% - 37%不符合NUP≥90 mL/小时标准的NP诊断。
夜间排尿过多指标不能可靠地预测女性的GP。完整的排尿日记在评估有夜尿症的女性中可能特别重要。女性夜尿症值得作为一个独特的实体进一步研究。