Nocturnal urination could be a health signal

Urologists Warn: Nocturia is often an alarm
Waking up every night, because the bladder calls for a toilet, is a widespread affliction - and a dangerous one at the same time. Firstly, the consequences of the regular interruption of nighttime sleep for urination, termed nocturia, are underestimated. On the other hand, the nocturnal toilets are often an alarm signal that indicates a disease requiring treatment.

"By mistake, nocturia is often dismissed in the population as an unavoidable symptom of aging, predominantly of the male, although it requires the clarification of individual causes," says Prof. Dr. med. Kurt Miller, President of the German Society for Urology e.V. (DGU), which discusses the Volksleiden at the 68th DGU Congress from September 28 to October 1, 2016 in Leipzig.

In fact, nocturia is the leading cause of sleep disorders, which in turn results in risks to the health and life expectancy of those affected. Contrary to popular belief, men and women alike are affected. Reliable current figures on frequency do not exist, but older studies show that more than 60 percent of people aged 70 and over suffer from a nocturia requiring treatment that urges them to urinate twice or more a night. Although advanced age is a major factor in nocturia, it does not save younger people from it. In the age group of 20- to 40-year-olds, about one in five to six are affected - more women than men here.

Nocturnal urination may indicate serious illnesses. Image: michaelheim - fotolia

"Nocturia is not an independent chronic disease, but a symptom of other physical disorders. Different causes can be considered for the urge to nocturnal urination, which are initially in the urine production as well as in the system of storage and discharge of urine to seek, "says Prof. Dr. med. Stephan Roth. Numerous nocturia patients have nocturnal polyuria. At night, they excrete more than the usual amount of 24-hour urine, which should be for younger people to 20 percent, beyond 65 to 33 percent. Other patients have a reduced capacity of the bladder, which requires more frequent emptying of smaller amounts. Especially in the elderly, there are often several factors that can cause nocturia: these include the declining ability to hold urine, increased residual urine volume, changes in the detrusor muscle, low concentration of the antidiuretic hormone (ADH), chronic lower urinary tract infections, overactive bladder and in men also an enlarged prostate.

According to the director of the Department of Urology and Pediatric Urology at the University Hospital Wuppertal, "In case of a polyuria, it is necessary to clarify the causes of increased nocturnal urine production". According to Roth, cardiac insufficiency, for which an excess of tissue water to be eliminated would be an indication, may be considered; Diabetes, elevated systolic blood pressure, or renal function disorders, as well as medications, can also affect urine output.

Snoring, which affects more than half of all men, and nocturnal breathing pauses (sleep apnea) are closely associated with nocturia, which is even considered a hallmark of obstructive sleep apnea syndrome. If this dangerous sleep disorder is effectively treated, then the urge for nocturnal urination improves. Obesity is another risk factor for nocturia.

The consequences of nocturia can be severe: sleep disorders often lead to daytime fatigue, lack of concentration, decreased mental performance and headaches. In some cases depression can be the result. Danish researchers found that nocturia can reduce labor productivity by up to 24 percent. Especially the elderly have increased risks for falls and broken bones. Patients with heart disease are at increased risk of mortality with nocturia.

"In view of the high level of suffering, possible complications and the sometimes serious causative diseases, the necessity for a thorough medical evaluation of nocturia becomes clear", sums up DGU President Prof. Dr. med. Kurt Miller and invites the media representatives to inform themselves at the 68th DGU Congress in Leipzig on the underrated popular suffering. (Pm)