Nocturnal Polyuria in Older Women with Urge Urinary Incontinence: Role of Sleep Quality, Time in Bed and Medications Used

Tyagi, Shachi; Perera, Subashan; Clarkson, Becky; Tadić, Staša; Resnick, Neil M.

doi:10.1016/j.juro.2016.09.080

Cited by 7 publications

(9 citation statements)

References 28 publications

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“…This may also have been because severe LUTS, including concomitant urge incontinence and nocturia, can be improved by increasing the dose of tamsulosin. This result is consistent with that of a previous investigation, in which Tyagi et al [21] reported an association between urge incontinence and nocturnal polyuria in older women. Further studies should be conducted into whether interventions to reduce nocturnal polyuria are associated with the duration of uninterrupted sleep and urge incontinence.…”

Section: Discussionsupporting

confidence: 94%

A Prospective, Multicenter, Open-Label Study of Dose Escalation Therapy in Male Patients With Nocturia Refractory to 0.2-mg Tamsulosin Monotherapy

Lee

et al. 2019

Int Neurourol J

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To investigate the efficacy and safety of 0.4 mg of tamsulosin in patients with nocturia not responding to 0.2 mg. Methods: Patients with intractable nocturia after treatment with 0.2 mg of tamsulosin for > 1 month were included in a multicenter, prospective, observational, single-arm study. Patients were prescribed 0.4 mg of tamsulosin and followed up for 2 months to assess nocturnal voiding and nocturia-related bother. Changes in the mean number of nocturnal voids, the proportion of 50% responders, 3-day frequency-volume chart parameters, and questionnaire scores were assessed. Results: Sixty-two patients were prescribed 0.2 mg of tamsulosin, of whom 56 were prescribed 0.4 mg of tamsulosin. Ten patients dropped out. A single case of orthostatic hypotension was reported. The mean age was 68 years. After 1 and 2 months of taking 0.4 mg of tamsulosin, 23.9% and 22.7% of patients demonstrated a > 50% reduction of nocturia, and 16.1% and 19.4% of patients rated the treatment as "very effective, " respectively. Dose escalation to 0.4 mg of tamsulosin, compared to 0.2 mg, did not show an additional effect on reducing nocturnal urine volume. Multivariate logistic regression analysis showed that lower serum sodium levels (odds ratio [OR], 0.41, P = 0.037) and the presence of urge incontinence (OR, 7.08, P = 0.036) were predictors of a significant improvement of nocturia in response to 0.4 mg of tamsulosin. Conclusions: Dose escalation may yield a significant improvement of nocturia in > 20% of patients, and may be especially helpful in patients with lower sodium levels and urge incontinence.

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Section: Discussionsupporting

confidence: 94%

A Prospective, Multicenter, Open-Label Study of Dose Escalation Therapy in Male Patients With Nocturia Refractory to 0.2-mg Tamsulosin Monotherapy

Lee

et al. 2019

Int Neurourol J

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“…22 Based on the findings of the present study, NP may be improved by controlling blood pressure to lower it during sleep. Regarding antihypertensive agents, angiotensin receptor blockers (ARBs) have been reported to be effective for NP, 23 while Ca blockers may conversely cause nocturia. [24][25][26][27][28] However, the previous report on ARBs for NP was found to be effective only in women, and no significant difference in ARBs use was observed only in male patients aged 65 years or older in this study.…”

Section: Discussionmentioning

confidence: 99%

Association between nocturnal polyuria and 24‐h blood pressure fluctuations in males with lower urinary tract symptoms: A multicenter prospective study

Kato,

Akaihata,

Takezawa

et al. 2023

Int J of Urology

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ObjectivesNocturnal polyuria (NP) is one of the causes of nocturia that impairs quality of life. It is necessary to consider that NP is latent when the initial treatment for nocturia is unsatisfactory. Therefore, it is important to establish a treatment for NP based on the pathophysiology. We have previously reported the relationship between NP and fluctuation in blood pressure. The present study aimed to investigate the association between NP and 24‐h blood pressure fluctuations in a multicenter prospective study.MethodsThis study included male patients with lower urinary tract symptoms. We categorized the patients into the nonnocturnal polyuria (non‐NP) group (≤0.33) and the NP group (>0.33) based on the nocturnal polyuria index from the frequency volume chart. We measured the 24‐h diurnal blood pressure and compared the two groups.ResultsAmong 90 patients, 46 in the non‐NP group and 44 in the NP group were included. There was no significant difference in the systolic and diastolic blood pressure during waking time between the two groups; however, the degree of systolic blood pressure reduction during sleep time in the NP group was significantly less than that in the non‐NP group (p = 0.039). In the multivariate analysis, systolic BP during sleep was significantly associated with NP (OR 0.970, p = 0.028).ConclusionNP is associated with inadequate nocturnal blood pressure reduction in males, suggesting that reduction in nocturnal blood pressure may lead to improvement in nocturia.

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“…And quitting smoking has been regarded as one of the lifestyle changes to improve UI (John, 2020). The polyuria caused by renal dysfunction can also lead to the occurrence of UI (Tyagi et al, 2017), which reminding clinician of alerting the diuretics in patients with CKD.…”

Section: Discussionmentioning

confidence: 99%

The relationship between Nephrotoxic Metals of cadmium, lead and mercury with Urinary Incontinence in Women

Lu³

et al. 2022

Preprint

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Purpose: Nephrotoxic metals of cadmium, lead and mercury are the common hazardous pollutants existing in surroundings. We examined the relationship between cadmium, lead and mercury with urgency urinary incontinence (UUI) and stress urinary incontinence (SUI) in women.Materials and Methods: The women older than 20 years from the 2007-2016 National Health and Nutrition Examination Survey (NHNES) with the ascertained urinary incontinence through self-report were included. This study conducted the restricted cubic spline analysis to analyze characterize a dose-response relationship between a continuous exposure of different nephrotoxic metals and UUI and SUI.Results: A total of 4,406 women were included in this study, with 2,624 (59.6%) were SUI and 3,177 (72.1) were UUI of the weighted population. The results of multivariate analysis indicated that age, race, marital status, body mass index (BMI) and nephrotoxic metals were risk factors for the odds of UUI and SUI. The odds ratio (OR; 95% confidence interval) of urinary incontinence were positively correlated with cadmium and lead in women. The OR of SUI increased with the increasing blood cadmium, possessing the maximum at 4 μg/L (2.18(1.34-3.58) overall). The odds of UUI increased with the blood and urinary lead, which reached the maximum at 7 μg/dL (2.03 (1.38-3.02) overall) and 5 μg/L (2.24 (1.34-3.75) overall) respectively.Conclusions: Nephrotoxic metals of cadmium and lead were associated the odds of urinary incontinence in women. Excessive exposure to these metals will increase the OR of UUI and SUI in adult women.

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Nocturnal Polyuria in Older Women with Urge Urinary Incontinence: Role of Sleep Quality, Time in Bed and Medications Used

Cited by 7 publications

References 28 publications

A Prospective, Multicenter, Open-Label Study of Dose Escalation Therapy in Male Patients With Nocturia Refractory to 0.2-mg Tamsulosin Monotherapy

A Prospective, Multicenter, Open-Label Study of Dose Escalation Therapy in Male Patients With Nocturia Refractory to 0.2-mg Tamsulosin Monotherapy

Association between nocturnal polyuria and 24‐h blood pressure fluctuations in males with lower urinary tract symptoms: A multicenter prospective study

The relationship between Nephrotoxic Metals of cadmium, lead and mercury with Urinary Incontinence in Women

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