The Nocturia in BPH

ABSTRACT

PURPOSE: Nocturia is one of the most bothersome of all benign prostatic hyperplasia(BPH) symptoms. Nocturia with BPH is generally thought to be closely associated with change of detrusor receptor and infection secondary to bladder outlet obstruction. However, age-associated physiological changes in bladder function and concurrent disease, for example, congestive heart failure, cause nocturia in elderly. Therefore, in BPH with nocturia, evaluation for etiology of nocturia is important for proper control of nocturia permanently and this study was performed to investigate the underlying etiology of nocturia. MATERIALS AND METHODS: The twenty-seven BPH patients who complained more than three times of nocturia were included in this study. Evaluation included voiding diary for 24 hour, and urodynamic study. Based on diary and urodynamic study, functional bladder capacity was determined and etiology of nocturia was classified into one of three groups noctural polyuria, hyperactivity nocturia and functional nocturia. Noctural polyuria was defined as overnight urine volume is over than 33% of 24 hour urine volume, hyperactive nocturia as the number of nocturia is more than (overnight urine volume/functional bladder capacity)-1 and functional nocturia as the number of nocturia is equal to (overnight urine volume/functional bladder capacity)-1. RESULTS: Overall 7(26%) had noctural polyruia. 4(15%) hyperactive nocturia and 13(48%) were mixed with noctual polyuria and hyperactive nocturia. The other 3(11%) were classified into functional nocturia. CONCLUSIONS: The cause of nocturia in the patient with BPH was multifactorial and unrelated to bladder outlet obstruction in significant proportion of BPH patients. Therefore in BPH patients with nocturia, we think that sufficient evaluation to find cause of nocturia is needed preoperatively and treatment should be directed to each condition with BPH management.