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Urologists warn: nocturia often gives an alarm signal
Waking up every night because the bladder requires you to go to the toilet is a common ailment - and a dangerous one at the same time. On the other hand, the nocturnal toilet visits are often an alarm signal that indicates an illness in need of treatment.
"Nocturia is mistakenly dismissed by the population as an inevitable symptom of aging, primarily of men, although it is necessary to clarify the individual causes," says Prof. Dr. Kurt Miller, President of the German Society for Urology (DGU), which deals with people's suffering at the 68th DGU Congress from September 28 to October 1, 2016 in Leipzig.
In fact, nocturia is the most common cause of sleep disorders, which in turn poses risks to the health and life expectancy of those affected. Contrary to popular belief, men and women are equally affected. There are no reliable current figures on the frequency, but according to older studies, more than 60 percent of all people aged 70 and over suffer from a nocturia that requires treatment and drives the person to urinate twice or more per night. Advanced age is an essential factor for nocturia, but it does not prevent younger people from doing so. In the 20- to 40-year-old age group, about every fifth to sixth person is affected - more often women than men.
“Nocturia is not an independent chronic disease, but a symptom of other physical disorders. Different causes come into consideration for the urge to urinate at night, which are initially to be found in the area of urine production and in the system for storing and draining the urine, ”says Prof. Stephan Roth. Many nocturia patients have nocturnal polyuria. At night they excrete more than the usual 24-hour urine volume, which should be up to 20 percent for younger people and over 65 to 33 percent. In other patients, a reduced urinary bladder capacity is found, which necessitates the frequent emptying of smaller amounts. In older people in particular, there are often several factors that can be the cause of a nocturia: These include the decreased ability to hold urine, increased residual urine volume, changes in the detrusor muscle, low concentration of the antidiuretic hormone (ADH), chronic infections of the lower urinary tract, overactive bladder and an enlarged prostate in men.
"In the case of polyuria," continued the director of the Clinic for Urology and Pediatric Urology at the University Clinic in Wuppertal, "it is necessary to clarify the causes of the increased nightly urine production". According to Roth, heart failure is an option for which an excess of tissue water to be excreted would be an indication; Diabetes, increased systolic blood pressure or kidney function disorders, like medication, can also affect urine production.
Snoring, which affects more than half of all men, and nocturnal breathing interruptions (sleep apnea) are closely linked to nocturia, which is even considered a key symptom of obstructive sleep apnea syndrome. If this dangerous sleep disorder is treated effectively, the urge to urinate at night also improves. Overweight is considered as another risk factor for nocturia.
The consequences of nocturia can be serious: sleep disorders often lead to daytime tiredness, poor concentration, reduced mental performance and headaches. In some cases, depression can result. Danish researchers found that nocturia can reduce labor productivity by up to 24 percent. Older people in particular have an increased risk of falls and broken bones. An increased risk of mortality is assumed for cardiac patients with simultaneous nocturia.
"In view of the high level of suffering, possible complications and the sometimes serious causal diseases, the need for a thorough medical examination of a nocturia becomes clear", summarizes DGU President Prof. Kurt Miller and invites the media representatives to the 68th DGU Congress in To inform Leipzig about the underestimated people suffering. (pm)