Nocturia

Question 1

What is nocturnal enuresis?

Answer 1

Involuntary urination that happens at night while sleeping

Question 2

What is nocturia?

Answer 2

If a patient voids two or more times nightly

Question 3

What are some conditions that can cause nocturia?

Answer 3

uncontrolled HTN, poorly controlled diabetes, RLS, OSA, GERD, BPH, and CHF

Question 4

What are 2 causes of low volume bladder voids?

Answer 4

OAB and bladder outlet obstruction

Question 5

What is nocturnal polyuria?

Answer 5

Overproduction of urine at night with a normal 24 hour urine output

Question 6

How can OSA cause nocturnal polyuria?

Answer 6

Release of atrial natriuretic peptide due to negative intrathoracic pressure and stretching of the myocardium
ANP release causes vasodilation and inhibits aldosterone, resulting in increased sodium and water excretion

Question 7

CPAP can result in significant reductions in

Answer 7

ANP levels, nighttime urine volume, and in nocturia episodes in patients with OSA

Question 8

What questions do you ask for nocturia symptoms?

Answer 8

How often do you get up at night to void?
How much does waking at night to void bother you?
Are you afraid of falling, do you feel dizzy, or have you fallen when you get up?
How much are you drinking each day?
Salt intake?
New medications?
CHF, DM, edema?
OSA?
UTI? Dysuria? Hesitancy? Weak stream?

Question 9

What physical exam do you do for nocturia?

Answer 9

Evaluate for volume overload
Palpate lower abdomen
Check for peripheral edema
PVR
PSA

Question 10

In the clinic, for nocturia have patients fill out

Answer 10

Frequency volume chart

Question 11

What are initial measures that can be taken for nocturia?

Answer 11

Decreasing nocturnal urine output, reduction of overall fluid intake, reduction of salt intake, limit alcohol and caffeine intake at night, double voiding, pelvic floor muscle exercises

Question 12

What is double voiding?

Answer 12

Urinating while sitting comfortably on the toilet, leaning slightly forward, and then waiting 20 to 30 seconds to urinate again

Question 13

What are alpha adrenergic antagonists?

Answer 13

Flomax, Doxazosin, and Terazosin

Question 14

Bladder relaxant therapies can be offered to patients without BPH such as

Answer 14

Oxybutynin and Tolterodine

Question 15

Who should not be prescribed Mirabegron or Vibegron?

Answer 15

Patients with severe or uncontrolled HTN

Question 16

What medication can cause nocturia?

Answer 16

Atorvastatin