Document Detail


Nocturnal enuresis in older adults.
MedLine Citation:
PMID:  15181966     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Nocturnal enuresis is uncommon in older adults. The paucity of literature about this problem prompts us to review our cases to determine the management strategy. METHODS: Six older adults, including 2 females and 4 males, were evaluated for refractory nocturnal enuresis. Only 2 of them had minor daytime urge symptom. Most of them had failed in the treatment using anticholinergics and/or alpha-adrenergic blocker. Evaluation consisted of detailed medical history, voiding diary, and urodynamic studies. Clinical follow-up persisted for 12 months. We define nocturnal polyuria as nighttime urine amount being more than 35% of total daily urine amount. Bladder outlet obstruction in men was diagnosed based on the definition described by International Continence Society. RESULTS: The average age was 71 years (range 61-84). The average duration of the symptom was 3.1 months (range 0.5-6). Two patients had bladder outlet obstruction. Four patients used hypnotics for insomnia, which might result in difficult awakening on bladder distension. Nocturnal polyuria was found in 3 patients. Most patients had multiple factors contributing to their nocturnal enuresis except 1, who was found to have an enlarged prostate with chronic bladder distension. Specific treatments were given based on the causes for each patient. Hypnotics were discontinued for a certain meanwhile in some patients. Nocturnal polyuria was managed with afternoon diuretic or bedtime desmopressin. Bedtime anticholinergic agent was used in patients with detrusor overactivity. The patient with enlarged prostate and urinary retention was managed with indwelling catheter followed by elective transurethral prostatectomy. All patients were dry in the night following the treatment. CONCLUSIONS: Nocturnal enuresis in older adult is usually multi-factorial. Hypnotic usage and nocturnal polyuria are frequently overlooked. Detailed investigation is necessary to identify the causes. Tailored treatment may achieve satisfactory results.
Authors:
Alpha Dian-Yu Lin; Alex Tong-Long Lin; Kuang-Kuo Chen; Luke Sien-Shih Chang
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the Chinese Medical Association : JCMA     Volume:  67     ISSN:  1726-4901     ISO Abbreviation:  J Chin Med Assoc     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-06-08     Completed Date:  2004-07-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  101174817     Medline TA:  J Chin Med Assoc     Country:  China (Republic: 1949- )    
Other Details:
Languages:  eng     Pagination:  136-40     Citation Subset:  IM    
Affiliation:
Division of Urology, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Algorithms
Enuresis / etiology*,  therapy
Female
Humans
Male
Middle Aged
Polyuria / etiology,  therapy
Time Factors
Urinary Bladder Neck Obstruction / complications

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