中文版 
Nocturia
What is Nocturia
Nocturia has been defined by the International Continence Society as the complaint that the individual has to wake at night one or more times to void. Thus, a normal adult should not suffer from Nocturia if she does not take too much water before sleeping.

Types of Nocturia
Assessment of nocturia include patient history, urine test and physical examination. The most effective assessment of nocturia is voiding diary. By assessing voiding diary, types of nocturia can be identified. (Nocturnal Polyuria, Diminished Bladder Capacity, Mixed Type and Polyuria). Different treatments can be offered for different types of nocturia.

Nocturnal Polyuria
New researches show that more than 70% was caused by Nocturnal Polyuria. Nocturnal Polyuria is defined as the production of an abnormally large volume of urine during sleep. A normal adult can produce 1500 – 2000 ml urine a day with 250 – 350ml of each voiding. The voiding frequency should be ~ 6-8 times in the day time, but less than one time at night. Patients with Nocturnal Polyuria have normal urine output but produce more especially at night, leading to increase the number of voids at night. The international Continence Society defined Nocturnal Polyuria as a nighttime output of urine greater than of 20% of the daily total in the young (age less than 65) and 33 % in the elderly (age over 65), or more than 6.4ml/kg.
 
Main Causes:
  • Reversal of circadian urine production
  • Relatively low AVP(Anti-diuretic hormone) secretion at night
  • Late evening diuretics / fluid intake
Symptom:
  • Normal total daily urine output (about 1500-2000 ml)
  • A nighttime urine output greater than of 20% of the daily total in the young (age less than 65) and 33 % in the elderly (age over 65), or more than 6.4ml/kg.
Treatment:
  • Avoid the intake of diuretic drinks (such as tea, coffee and alcoholic drinks) before bed.
  • Medical treatment: AVP hormone supplements (Desmopressin acetate) can help to concentrate urine. (Desmopressin is similar to AVP hormone in our body. This medical treatment is safe. Fluid intake should be controlled during treatment).

Diminished Bladder Capacity
The functional bladder capacity is low at day and night. This increases the number of voids at day time as well as in night time.
 
Main causes:
  • Detrusor Overactivity
  • Urethral Obstruction
Symptom:
  • Number of voids increases in day and night
Treatment:
  • Patients suffering from Diminished Bladder Capacity always have other urology problems, such as Detrusor Overactivity, Urethral Obstruction. Treatment corresponding to these problems shall be prioritized and treated.

Mixed Type
Symptom:
  • Nocturnal Polyuria + Diminished Bladder Capacity
Treatment:
  • The main causes of Nocturia should be found out before treatment. Nevertheless, treatment of Nocturnal Polyuria is non-invasive and should be applied first. If the improvement is not obvious, other treatment should also be considered and adopted.

Polyuria
Both urine output in day time and night time increases.
 
Main causes:
  • Diabetes Insipidus
  • Diabetes Mellitus
Treatment:
  • Treat Diabetes Insipidus and Diabetes Mellitus accordingly.