1/9. A monthly period of symptoms associated with benign prostatic hyperplasia.The number of times that a man with benign prostatic hyperplasia awoke each night with the urge to urinate (nocturia) was analyzed for randomness by Bartlett's Kolmogorov-Smirnov white noise test and for a periodic component by fourier analysis. The data series (n = 1549) was not white noise; it had a peak periodic component of 25 days, with a range of 21 to 37 days. The possibility that the monthly period of nocturia is a general phenomenon and is coupled to a monthly menstrual period, and the implications for more accurate diagnosis and new modes of therapy, are discussed.- - - - - - - - - - ranking = 1keywords = nocturia (Clic here for more details about this article) |
2/9. Successful treatment of partial nephrogenic diabetes insipidus with thiazide and desmopressin.OBJECTIVE: To clarify whether combination treatment with desmopressin (DDAVP) and thiazide was clinically effective in a patient with congenital nephrogenic diabetes insipidus (CNDI), we evaluated the treatment in a 7-year-old boy with CNDI who had demonstrated a partial response to DDAVP. METHOD: Both volume of urine and the presence of nocturia were determined during treatment. RESULT: Neither the usual therapy of a low-salt diet and a thiazide nor intranasal therapy with a large dose of DDAVP was effective. However, combination treatment resulted in a decrease in urinary volume and the disappearance of nocturia. CONCLUSION: DDAVP coupled with thiazide may be useful for CNDI in patients who have shown a partial response to DDAVP.- - - - - - - - - - ranking = 1keywords = nocturia (Clic here for more details about this article) |
3/9. Sliding hernia of the bladder presenting as suprapubic pain in a female.We report a case of bilateral sliding hernia of the bladder in a 64-year-old woman who presented with suprapubic pain and nocturia and was diagnosed by voiding diary and cystogram.- - - - - - - - - - ranking = 0.5keywords = nocturia (Clic here for more details about this article) |
4/9. Effects of pergolide on nocturia in Parkinson's disease: three female cases selected from over 400 patients.We started the subject screening from over 400 patients with Parkinson's disease using strict selection criteria to identify the patients with nocturia who would allow accurate and efficient evaluation of the pergolide effects. The subjects were confined to female patients to exclude patients with potential prostate hypertrophy. The patients treated with bromocriptine at 7.5-15 mg/day adjunctive to l-dopa were selected to replace bromocriptine with pergolide of the equivalent dosage approved in japan. The nocturia was defined as having more than two episodes of urination during sleep per night on average. The subjects received the urinary sediment test before and during the study for screening urinary tract infection and the study was discontinued when urinary tract infection was found. As a result, we identified total 11 patients with nocturia and three of those completed the 12-week study of switching dopamine agonist from bromocriptine to pergolide. We observed a decrease in nocturia frequency in all three patients, a decrease in irritative urinary symptoms in two and an improvement of sleep QOL in two. The effect of pergolide on nocturia was independent of improvement of parkinsonian symptoms, suggesting a distinct mechanism from that of anti-parkinsonian effects. Our study also suggests that switching from bromocriptine to pergolide improves nocturia, thereby improving sleep status of patients with Parkinson's disease.- - - - - - - - - - ranking = 5keywords = nocturia (Clic here for more details about this article) |
5/9. Occupational bladder cancer in a 4,4 -methylenebis(2-chloroaniline) (MBOCA)-exposed worker.A 52-year-old male chemical worker was admitted to the hospital with a history of paroxysmal microscopic hematuria for about 2 years and nocturia with gross hematuria about five times per night for 2 months. He was a nonsmoker and denied a history of any other bladder carcinogen exposure except for occasional pesticide application during agricultural work. Intravenous urogram imaging showed a mass occupying half of the bladder capacity. cystoscopy revealed a mass over the left dome of the bladder. Cystoscopic biopsy revealed a grade 3 invasive transitional cell carcinoma with marked necrosis. From 1987 until hospital admission in 2001, the patient had worked in a company that produced the 4,4 -methylenebis(2-chloroaniline) (MBOCA) curing agent. He did not wear any personal protective equipment during work. Ambient air MBOCA levels in the purification process area (0.23-0.41 mg/m3) exceeded the U.S. Occupational safety and health Administration's permissible exposure level. Urinary MBOCA levels (267.9-15701.1 microg/g creatinine) far exceeded the california Occupational safety and health Administration's reference value of 100 microg/L. This patient worked in the purification process with occupational exposure to MBOCA for 14 years. According to the environmental and biologic monitoring data and latency period, and excluding other potential bladder carcinogen exposure, this worker was diagnosed as having occupational bladder cancer due to high exposure to MBOCA through inhalation or dermal absorption in the purification area. This case finding supports that MBOCA is a potential human carcinogen. Safe use of skin-protective equipment and respirators is required to prevent workers from MBOCA exposure.- - - - - - - - - - ranking = 0.5keywords = nocturia (Clic here for more details about this article) |
6/9. Effect of a GnRH analogue (leuprolide) on benign prostatic hypertrophy.To determine the effects of reversible medical castration on prostatic size in patients with benign prostatic hypertrophy (BPH), 3 patients with BPH were treated with a GnRH analogue, leuprolide, for six months at a dosage of .2ml (1 mg) s.c. daily. serum testosterone, dihydrotestosterone and estradiol fell to castration levels 4-6 weeks after the initiation of treatment and remained low throughout the study period. Transrectal ultrasonography of the prostate demonstrated an average decrease in prostatic volume of 58% at 6 months, with the greatest rate of decrease occurring during the 2nd to 5th months of treatment. One man who had acute urinary retention before treatment was subsequently able to void extremely well. In a second man the symptoms of prostatism diminished but in the third urinary frequency and nocturia persisted in spite of a reduction in prostatic size, presumably because his symptoms were due to renal insufficiency.- - - - - - - - - - ranking = 0.5keywords = nocturia (Clic here for more details about this article) |
7/9. Maximal dose glyburide therapy in markedly symptomatic patients with type 2 diabetes: a new use for an old friend.No consensus exists as to the best approach for treating markedly symptomatic patients with new-onset (or diet-treated) type 2 diabetes. Therefore, based on the experience of one successful case, further studies were undertaken to determine the safety and efficacy of maximal dose glyburide (10 mg, twice daily, in patients < 65 yr of age) or half the dose (10 mg, daily, in patients > or = 65 yr of age) for treating these patients. Fifty-five patients with polyuria, polydipsia, nocturia, involuntary weight loss, and blood glucose concentrations of 300 mg/dL or greater were treated following protocols that used maximal dose ( < 65 yr of age) or half-maximal dose ( > or = 65 yr of age) sulfonylurea agent therapy. Data were collected retrospectively in 30 patients and prospectively in 25. patients in the prospective group differed only in that more laboratory measurements were obtained, and less strict guidelines for using insulin were adopted. Data were collected in both groups at baseline and 1 week and 4 months after starting the sulfonylurea agent therapy. patients responded rapidly with a fall in blood glucose levels from 456 /- 12 mg/dL at baseline to 202 /- 10 mg/dL at 1 week to 120 /- 5 mg/dL at 4 months. Glycated hemoglobin levels fell from 18.1 /- 0.4% at baseline to 8.1 /- 0.2% ( P < 0.0001) at 4 months. Most patients had symptomatic improvement within 3 days. Seventeen patients had positive (small or larger) urinary ketones, and 5 had positive serum ketones. insulin to glucose and C peptide to glucose ratios improved maximally at 1 week, indicating rapid reversal of glucotoxicity on the beta-cell. At 4 months, 11 patients were receiving diet therapy alone, 29 were receiving submaximal dose sulfonylurea agent therapy, 6 remained on maximal dose sulfonylurea agent therapy, and only 3 were receiving insulin therapy. Six patients were lost to follow-up. No patient experienced hypoglycemia in the first 2 weeks of treatment. Maximal dose sulfonylurea agent therapy is a safe and effective method for treating patients with markedly symptomatic type 2 diabetes. patients improve rapidly and are able to avoid the immediate institution of long term insulin therapy.- - - - - - - - - - ranking = 0.5keywords = nocturia (Clic here for more details about this article) |
8/9. A non-urologic cause of nocturia and enuresis--obstructive sleep apnea syndrome (OSAS).Three case reports describe nocturia and enuresis as complications of the obstructive sleep apnea syndrome (OSAS). It is important to recognize the causal relationship since these troublesome symptoms are easily treated by treating the sleep apnea.- - - - - - - - - - ranking = 2.5keywords = nocturia (Clic here for more details about this article) |
9/9. dysuria due to bladder distortion after repeat cesarean section.Abnormalities of the lower urinary tract resulting from cesarean section are rare. We present a patient who developed urinary frequency, nocturia and acute pains in the late phase of micturition which we think was due to bladder distortion after repeat cesarean section. She was diagnosed cystographically and treated successfully by bladder flap release.- - - - - - - - - - ranking = 0.5keywords = nocturia (Clic here for more details about this article) |