Assessment of associated factors with nocturia in young and older urinary incontinent

Year 2022, Volume: 17 Issue: 2, 91 - 97, 30.06.2022

Mustafa Soytaş , Rabia Bağ Soytaş

https://doi.org/10.33719/yud.2022;17-2-1102536

Abstract

Objective: To assess the factors affecting nocturia in young and older women with urinary incontinence (UI).
Material and Methods: Women who applied to the urology outpatient clinic with the UI complaint between November 2021-March 2022 were included. Demographic data, anthropometric measurements, medications and comorbidities were recorded. The ICIQ-SF test was applied to evaluate their quality of life. Patients who have been waking up at night with the need to urinate ≥2 were considered to have nocturia.
Results: Ninety-two women were included. Two groups were created as patients <60 years (n=47) and ≥60 years (n=45). The body mass index and waist circumference were higher in patients ≥60 years (respectively; p= 0.034, p= <0.001). Using of diuretic and anticholinergic medications was higher than in the younger group (respectively; p= <0.001, p= 0.006). The total number of medications was higher in the older group (p= <0.001). The number of comorbidities and the number of patients with Type 2 Diabetes Mellitus (DM) were higher in the older group (respectively; p= 0.002, p= 0.025). No difference was found in the young group with and without nocturia in terms of anthropometric measurements, medications used, and comorbidities. The number of medications and the number of Type 2 DM patients were significantly higher in the older group with nocturia (respectively; p= 0.04, p= 0.036).
Conclusion: Type 2 DM and multiple medication use are risk factors for nocturia in older women with UI. Evaluation and management of these risk factors may contribute to better clinical outcomes.

Keywords

Aged , nocturia , risk factors , urinary incontinence , women

Üriner inkontinansı olan genç ve yaşlı kadınlarda noktüri ile ilişkili faktörlerin değerlendirilmesi

Abstract

Amaç: Üriner inkontinanslı (Üİ) genç ve yaşlı kadınlarda noktüriyi etkileyen faktörleri değerlendirmek.
Gereç ve Yöntemler: Kasım 2021-Mart 2022 tarihleri arasında Üİ şikâyeti ile üroloji polikliniğine başvuran kadınlar çalışmaya dahil edildi. Demografik veriler, antropometrik ölçümler, ilaçlar ve komorbiditeler kaydedildi. Yaşam kalitelerini değerlendirmek için ICIQ-SF testi uygulandı. Geceleri ≥2 idrar yapma ihtiyacı ile uyanan hastalarda noktüri var olarak kabul edildi.
Bulgular: Çalışmaya 92 kadın dahil edildi. Hastalar <60 yaş (n=47) ve ≥60 yaş (n=45) olarak 2 gruba ayrıldı. Bel çevresi ve vücut kitle indeksi ≥60 yaş hastalarda daha yüksekti (sırasıyla; p= <0,001, p= 0,034). Kullanılan ilaç sayısı yaşlı grupta daha fazlaydı (p= <0,001). Diüretik ve antikolinerjik ilaç kullanımı yaşlı grupta genç gruba göre daha yüksekti (sırasıyla; p= <0,001, p= 0,006). Tip 2 Diabetes Mellitus'lu (DM) hasta sayısı ve komorbidite sayısı yaşlı grupta daha fazlaydı (sırasıyla; p= 0,002, p= 0,025). Noktürisi olan ve olmayan genç grupta antropometrik ölçümler, kullanılan ilaçlar ve komorbiditeler açısından fark bulunmadı. Noktürisi olan yaşlı grupta ilaç sayısı ve Tip 2 DM olan hasta sayısı noktürisi olmayan yaşlı gruba göre anlamlı olarak daha yüksekti (sırasıyla; p= 0.04, p= 0.036).
Sonuç: Çalışmamızın sonuçları, klinisyenlerin özellikle Üİ'li yaşlı kadınlarda noktüri riskini azaltmak için kullanılan ilaç sayısını ve Tip 2 DM varlığını değerlendirmesinin önemini vurgulamaktadır.

Keywords

Yaşlı , noktüri , risk faktörleri , üriner inkontinans , kadın

References

• 1. Haylen BT, de Ridder D, Freeman RM, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 2010;21(1):5-26. doi:10.1007/s00192-009-0976-9
• 2. Weiss JP, Blaivas JG, Blanker MH, et al. The New England Research Institutes, Inc. (NERI) Nocturia Advisory Conference 2012: focus on outcomes of therapy. BJU Int 2013;111(5):700-716. doi: 10.1111/j.1464-410X.2012.11749.x.
• 3. Oelke M, De Wachter S, Drake MJ, et al. A practical approach to the management of nocturia. Int J Clin Pract 2017;71(11):e13027. doi:10.1111/ijcp.13027
• 4. Soysal P, Cao C, Xu T, et al. Trends and prevalence of nocturia among US adults, 2005-2016. Int Urol Nephrol 2020;52(5):805-813. doi: 10.1007/s11255-019-02361-5.
• 5. Markland AD, Vaughan CP, Johnson TM 2nd, et al. Prevalence of nocturia in United States men: results from the National Health and Nutrition Examination Survey. J Urol 2011;185(3):998-1002. doi: 10.1016/j.juro.2010.10.083
• 6. Tikkinen KA, Tammela TL, Huhtala H, Auvinen A. Is nocturia equally common among men and women? A population based study in Finland. J Urol 2006;175:596. doi: 10.1016/S0022-5347(05)00245-4
• 7. Marshall SD, Raskolnikov D, Blanker MH, et al. Nocturia: Current Levels of Evidence and Recommendations From the International Consultation on Male Lower Urinary Tract Symptoms. Urology. 2015;85(6):1291-1299. doi: 10.1016/j.urology.2015.02.043
• 8. Leslie SW, Sajjad H, Singh S. Nocturia. [Updated 2022 Feb 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK518987/
• 9. Van Kerrebroeck P, Andersson KE. Terminology, epidemiology, etiology, and pathophysiology of nocturia. Neurourol Urodyn 2014;33:Suppl 1:S2–S5. doi: 10.1002/nau.22595
• 10. Cornu JN, Abrams P, Chapple CR, et al. A contemporary assessment of nocturia: definition, epidemiology, pathophysiology, and management--a systematic review and meta-analysis. Eur Urol 2012;62:877-890. doi: 10.1016/j.eururo.2012.07.004
• 11. Araujo AB, Yaggi HK, Yang M, et al. Sleep related problems and urological symptoms: testing the hypothesis of bidirectionality in a longitudinal, population based study. J Urol 2014;191:100-6. doi: 10.1016/j.juro.2013.07.011
• 12. Foley DJ, Vitiello MV, Bliwise DL, et al. Frequent napping is associated with excessive daytime sleepiness, depression, pain, and nocturia in older adults: findings from the National Sleep Foundation ‘2003 Sleep in America’ Poll. Am J Geriatr Psychiatry 2007;15:344–350. doi: 10.1097/01.JGP.0000249385.50101.67
• 13. Asplund R. Hip fractures, nocturia, and nocturnal polyuria in the elderly. Arch Gerontol Geriatr 2006;43(3):319-326. doi: 10.1016/j.archger.2005.12.002
• 14. Asplund R. Obesity in elderly people with nocturia: causemor consequence? Can J Urol 2007;14:3424–3428.
• 15. Pesonen JS, Cartwright R, Vernooij RWM, et al. The Impact of Nocturia on Mortality: A Systematic Review and Meta-Analysis. J Urol 2020;203(3):486–95. doi: 10.1097/JU.0000000000000463
• 16. Erekson EA, Ciarleglio MM, Hanissian PD, et al. Functional disability and compromised mobility among older women with urinary incontinence. Female Pelvic Med Reconstr Surg 2015;21(3):170-175. doi: 10.1097/SPV.0000000000000136
• 17. Cetinel B, Ozkan B, Can G. The validation study of ICIQ-SF Turkish version. Turkish J Urol 2004;30(3):332-338.
• 18. Varilla V, Samala RV, Galindo D, Ciocon J. Nocturia in the elderly: a wake-up call. Cleve Clin J Med 2011;78(11):757-764. doi: 10.3949/ccjm.78a.11025
• 19. Bing MH, Moller LA, Jennum P, Mortensen S, Lose G. Pathophysiological aspects of nocturia in a danish population of men and women age 60 to 80 years. J Urol. 2007;178(2):552-557. doi:10.1016/j.juro.2007.03.141
• 20. Vaughan CP, Bliwise DL. Sleep and Nocturia in Older Adults. Sleep Med Clin 2018;13(1):107-116. doi: 10.1016/j.jsmc.2017.09.010
• 21. Miu DK, Lau S, Szeto SS. Etiology and predictors of urinary incontinence and its effect on quality of life. Geriatr Gerontol Int 2010;10(2):177-182. doi: 10.1111/j.1447-0594.2009.00574.x
• 22. Soysal P, Smıth L, Dutoglu E, et al. Nocturia and Comprehensive Geriatric Assessment Parameters in Older Men. JoGS 2020; 3(3): 84-91. doi: 10.47141/geriatrik.820881
• 23. Dutoglu E, Soysal P, Smith L, et al. Nocturia and its clinical implications in older women. Arch Gerontol Geriatr 2019;85:103917. doi: 10.1016/j.archger.2019.103917
• 24. Izci Y, Topsever P, Filiz TM, et al. The association between diabetes mellitus and urinary incontinence in adult women. Int Urogynecol J Pelvic Floor Dysfunct 2009;20(8):947-952. doi: 10.1007/s00192-009-0888-8
• 25. Golbidi S, Laher I. Bladder dysfunction in diabetes mellitus. Front Pharmacol. 2010;1:136. Published 2010 Nov 16. doi:10.3389/fphar.2010.00136
• 26. Tikkinen KA, Auvinen A, Johnson TM 2nd, et al. A systematic evaluation of factors associated with nocturia--the population-based FINNO study. Am J Epidemiol 2009;170(3):361-368. doi: 10.1093/aje/kwp133
• 27. Wang TT, Chung MH, Chien HY, Palmer MH, Liao CH, Liao YM. Nocturia in Women With Type 2 Diabetes Mellitus: A Cross-sectional, Correlation Study. J Wound Ostomy Continence Nurs. 2020;47(3):265-272. doi:10.1097/WON.0000000000000635
• 28. Wu MY, Wu YL, Hsu YH, et al. Risks of nocturia in patients with chronic kidney disease--do the metabolic syndrome and its components matter? J Urol 2012 Dec;188(6):2269-73. doi: 10.1016/j.juro.2012.08.008