What Are the Causes of Nocturia in Elderly Men?

Low nocturnal bladder capacity

Many patients with nocturia have a combination of nocturnal polyuria and low nocturnal bladder capacity. Notably low bladder capacity (nocturnal bladder capacity index > 2) may result from bladder obstruction, bladder overactivity, sensory urgency, or primary bladder conditions such as infection, inflammation, Interstitial cystitis, or malignancy. Recognising and treating the underlying disorder would be expected to alleviate or at least ameliorate symptoms of nocturia.


What type of professional should you see?

While you may be uncomfortable addressing the issue with others, a medical professional is able to provide you with options to help alleviate and in some cases treat nocturia.

If you believe that you are experiencing nocturia and/or nocturnal polyuria, you should first see a primary care professional such as a family care physician, nurse practitioner, physician’s assistant, or general practitioner. This could also be an internist or geriatrician serving as your primary care provider. Once your provider has determined if, in fact, you have this condition, you should be referred to a specialist:

  Urologist
  Urogynecologist
  Gynecologist
  Neurologist
  Sleep Expert
  Endocrinologist

Nocturia is multifactorial and is caused by factors that increase urine production and others that decrease the bladder’s ability to hold urine.

The first priority in treating nocturia is to identify and treat concomitant conditions that may be contributing to it, such as diabetes mellitus, diabetes insipidus, urinary tract infections, hypercalcemia, and hypokalemia.

Nonpharmacologic measures can help, but by themselves usually do not solve the problem.

Drug therapies for nocturia include desmopressin (DDAVP), antimuscarinic agents, alpha-blockers, and 5-alpha reductase inhibitors.

 


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Varilla V, Samala RV, Galindo D, Ciocon J.
Source - Cleveland Clinic Florida, Weston, FL 33331, USA.

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