These results suggest that sleep disturbance, hypertension, and excessive fluid intake are major factors contributing to an increased frequency of nocturnal urination (>twice per night) in the elderly.

Calcium oxalate supersaturation of the blood is associated with deposition of crystals in various tissues. We measured the serum levels of oxalate, citrate, calcium, and magnesium to estimate their saturation in 112 hemodialysis patients without primary hyperoxaluria and two boys with primary hyperoxaluria. Serum levels of oxalate and citrate were determined by high-performance capillary electrophoresis, while calcium and magnesium were measured by ICP spectroscopy. The serum levels of oxalate, citrate, calcium, and magnesium were 44.9+/-16.5, 138.1+/-54.9 micromol/l, 2.30+/-0.28, and 1.07+/-0.18 mmol/l, respectively, while the levels in patients with primary hyperoxaluria were 83.9+/-34.3, 197.9+/-63.5 micromol/l, 2.53+/-0.15, and 1.14+/-0.34 mmol/l, respectively. Serum calcium oxalate saturation (SS), as calculated by the Equil program, was significantly correlated with the serum oxalate level. Most patients showed metastable supersaturation (1

This electrophysiological study demonstrated that the subcoeruleus nucleus and nucleus raphe magnus are involved in both urine storage and penile erection, and that their physiological functions are reciprocally controlled; so that erection leads to inhibition of micturition.

We investigated whether nocturia in the elderly was improved by walking exercise, which involved walking rapidly for 30 min or more in the evening or night for 8 weeks. A questionnaire related to micturition and exercise, blood pressure, body composition analysis, blood biochemistry tests, and urinalysis were performed before and after 8 weeks of exercise to investigate the effects of walking. Thirty men (71 years old on average) continued the walking exercise for long enough to undergo evaluation. The number of episodes of nocturia decreased significantly (p < 0.001) from 3.3 ± 0.7 to 1.9 ± 0.8 after 8 weeks of walking exercise. The daytime urinary frequency, blood pressure, body weight, body fat ratio, edema ratio, serum catecholamines, triglycerides, and total cholesterol were also decreased. After 8 weeks of exercise, 20 of the subjects (67%) stated that sleep was deeper than before exercise. Assessment of the overall improvement showed that excellent or good results were obtained in 18 patients (60%). The main factor related to the influence of walking exercise on nocturia was that sleep became deeper, which increased the arousal threshold bladder volume. Walking exercise may also have a preventive effect on lifestyle-related diseases.

Background : Transabdominal ultrasonography was used to study the bladder neck morphology in women with urethral syndrome or stress urinary incontinence, in order to determine the ultrasonographic findings of these conditions. Methods : A total of 210 female patients with a normal bladder, asymptomatic trigonitis, urethral syndrome, and stress incontinence were studied. The mucosal thickness around the bladder neck, the length of the anterior base plate of the bladder, and the anteroposterior vesical wall angle (APVA) at the bladder neck were measured on sagittal transabdominal vesical ultrasonograms with the patient in the supine position.Results : Patients with asymptomatic trigonitis or urethral syndrome had thicker mucosa around the bladder neck than the subjects with a normal bladder, and the subjects with stress incontinence had normal mucosa. The APVA was 158 ± 17 (mean ± SD) degrees in the subjects with a normal bladder. It was smaller in symptomatic patients and decreased to 109 ± 10 degrees in those with conservative therapy-resistant incontinence. The anterior edge of the vesical base plate was visible approximately 2 cm from the bladder neck in subjects without incontinence, while it tended to be absent in patients with incontinence and an APVA of less than 126 degrees. Conclusion : A small APVA appears to reflect bladder neck descent, while a small APVA without a visible anterior base plate edge may reflect hypotonia of the vesical base plate. Transabdominal vesical ultrasonography with the patient in the supine position provides useful information and can be carried out as a routine examination in female patients with micturition disorders. Key wordsanteroposterior vesical wall angle, bladder base plate, bladder neck, women.