04November 2016

Elderly people with nocturia

In the physiological changes of the elderly, night urination is one of the most common conditions.

Urination can be volume (polyuria, urinating more than 2.5 liters in 24 hours) or the number of urination times (frequent urination). Normal people can urinate 4-8 times / day. If you urinate more than 8 times / day or have to wake up to urinate more than 1 time during the night, this is considered a heavy urination.

Nguyên nhân

If you have to wake up many times at night to urinate, it can be due to the following factors: impaired brain inhibition of the bladder reflex, behavior of the elderly becomes like children. ; appear enlargement of the prostate gland with benign tumors (enlargement of the prostate is often caused by benign tumors, malignant tumors are rare).

The prostate gland is located at the bottom of the bladder and covers the urethra. When this gland appears, enlarged tumors will compress the bladder neck, causing difficulty in urination and not going away, so the bladder is very quickly full. 

Furthermore, varicose veins here reduce cheek circulation in the prostate gland, causing mucosal edema in the bladder neck. A benign prostate tumor usually grows slowly and dull, it can coexist peacefully with the patient for decades provided that it does not make the patient suffer from urinary disorder to the extent that it cannot stand it. 

Complications of prostate tumors cause are chronic urinary retention, urinating for a long time, urinating not all, increasing urine capacity, someone has to clear the bladder to urinate. Patients also feel heavy and uncomfortable in the hypotenic region. 

Left untreated, severe illness can cause dangerous complications of kidney inflammation and kidney failure. For people with fibroids that enlarge the prostate gland need to see a specific level of disease to be treated. There are many cases that are treated with drugs or can be endoscopic, surgery to remove the tumor. However, in many surgical cases it is very likely that the patient will experience an inverse ejaculation, which means that semen flows back into the bladder because the sphincter system that closes the bladder neck during ejaculation is destroyed This is information the patient should know and accept. 

In order to detect the disease early, especially to prevent malignancies in the prostate gland, men over 40 years old need to have an annual prostate examination. When there are signs of difficulty urinating need to be examined early to be treated promptly and avoid urinary tract infections.

For people with diabetes, the early sign of type 1 and type 2 diabetes is heavy urination. This symptom also occurs when diabetes has complications on the nerves that control the bladder.

Too much urination can also be caused by using diuretics. Diuretics used to treat high blood pressure and edema due to heart failure, kidney failure and cirrhosis are also the cause of excessive urination.

Due to stroke and neuropathy, nerve damage that governs the bladder can lead to bladder dysfunction, causing excessive urination and sudden urination.

Using artificial sweeteners, coffee, alcohol and foods with diuretic effects; Water containing sweeteners, artificial sugars and citrus in fruit work to stimulate the bladder to cause more urination.

Cách khắc phục

To prevent nocturia, the elderly need periodic medical examinations to know the cause and timely treatment.

For people who urinate at night due to neurological impairment in the brain, it is necessary to overcome with measures such as limiting drinking water at night, before going to bed remember to urinate. On the other hand, to avoid brain accidents when waking up in the middle of the night, it is necessary to sit up slowly and be alert before getting out of bed. If there is no toilet in the house, use a potty to urinate, not open the door to urinate outdoors.

For the elderly who do not have some diseases such as diabetes, urinary tract infections or prostate fibroids, hypertension, diabetes mellitus … should limit eating soup during dinner and after dinner. especially vegetables, broth with diuretic properties such as cabbage … limit drinking water, beer, especially cold beer before going to bed. To limit drinking water, do not eat salty.

For the elderly with some urinary tract infections, it is necessary to see a doctor as soon as possible, should not let the disease become chronic, difficult to treat and suffer from nocturia. Diseases such as diabetes, fibroids, urinary tract stones (kidney stones, ureteral stones, bladder stones), hypertension also need to be actively treated to quickly stabilize and limit. nocturia.

Elderly people should exercise lightly before going to bed at night to make sleep longer, sleep more deeply, forget about having to urinate at night. Do not let the air get too cold to sleep (it should be warm enough in winter, summer should not be under the air conditioner) because cold causes peripheral vasoconstriction, increasing blood passing through the kidneys and urine is also increased faster

Limit the creation of habits that lead to insomnia such as: working too much at night, using tea and coffee in the evening.

(Source: Central Health Communication Center)

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