Kim Pauwaert1, An-Sofie Goessaert2, Lynn Ghijselings3, Thomas F Monaghan4, Herman Depypere5, Karel Everaert3. 1. Department of Urology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium. kim.pauwaert@ugent.be. 2. Faculty of Medicine and Health Science, Department of Human Structure and Repair, Ghent University, Ghent, Belgium. 3. Department of Urology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium. 4. Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA. 5. Department of Gynecology, Ghent University Hospital, Ghent, Belgium.
Abstract
INTRODUCTION AND HYPOTHESIS: Nocturia, defined as the act of waking to pass urine during sleeping, is a common problem in older women and is associated with significant morbidity and impairments in health-related quality of life. The aim of this review was to synthesize the current evidence regarding the incidence, impact, pathophysiology, and specific diagnostic approach of nocturia in the postmenopausal population. METHODS: We searched PubMed and Web of Science databases to identify relevant studies published through June 2020. Reference lists of the reviews obtained were screened for other articles deemed pertinent by the authors. RESULTS: Genitourinary symptoms attributed to the menopause have been reported to occur in nearly 90% of postmenopausal women, and nocturia is one of the most common. The relative deficiency in endogenous estrogen production after the menopause is thought to exacerbate all major pathophysiological mechanisms that may underlie nocturia, including reduced bladder capacity, nocturnal polyuria, global polyuria, and sleep disorders. Diminished estrogen may induce anatomical and physiological bladder changes, contributing to a reduction in functional bladder capacity. Excess nocturnal urine production can also be provoked by estrogen depletion, either via free water-predominant diuresis by an impaired secretion of antidiuretic hormone, or a salt-predominant diuresis owing to diminished activation of the renin-angiotensin-aldosterone axis. Additionally, a relationship between the transition to menopause and impaired sleep has been described, mediated by increased incidence in vasomotor symptoms and obstructive sleep apnea signs during the menopause. CONCLUSION: Further research is necessary to better characterize and manage nocturia in postmenopausal women.
INTRODUCTION AND HYPOTHESIS: Nocturia, defined as the act of waking to pass urine during sleeping, is a common problem in older women and is associated with significant morbidity and impairments in health-related quality of life. The aim of this review was to synthesize the current evidence regarding the incidence, impact, pathophysiology, and specific diagnostic approach of nocturia in the postmenopausal population. METHODS: We searched PubMed and Web of Science databases to identify relevant studies published through June 2020. Reference lists of the reviews obtained were screened for other articles deemed pertinent by the authors. RESULTS: Genitourinary symptoms attributed to the menopause have been reported to occur in nearly 90% of postmenopausal women, and nocturia is one of the most common. The relative deficiency in endogenous estrogen production after the menopause is thought to exacerbate all major pathophysiological mechanisms that may underlie nocturia, including reduced bladder capacity, nocturnal polyuria, global polyuria, and sleep disorders. Diminished estrogen may induce anatomical and physiological bladder changes, contributing to a reduction in functional bladder capacity. Excess nocturnal urine production can also be provoked by estrogen depletion, either via free water-predominant diuresis by an impaired secretion of antidiuretic hormone, or a salt-predominant diuresis owing to diminished activation of the renin-angiotensin-aldosterone axis. Additionally, a relationship between the transition to menopause and impaired sleep has been described, mediated by increased incidence in vasomotor symptoms and obstructive sleep apnea signs during the menopause. CONCLUSION: Further research is necessary to better characterize and manage nocturia in postmenopausal women.
Authors: Jori S Pesonen; Rufus Cartwright; Robin W M Vernooij; Yoshitaka Aoki; Arnav Agarwal; Altaf Mangera; Alayne D Markland; Johnson F Tsui; Henrikki Santti; Tomas L Griebling; Alexey E Pryalukhin; Jarno Riikonen; Riikka M Tähtinen; Camille P Vaughan; Theodor M Johnson; Anssi Auvinen; Diane Heels-Ansdell; Gordon H Guyatt; Kari A O Tikkinen Journal: J Urol Date: 2019-07-31 Impact factor: 7.450
Authors: Jori S Pesonen; Robin W M Vernooij; Rufus Cartwright; Yoshitaka Aoki; Arnav Agarwal; Altaf Mangera; Alayne D Markland; Johnson F Tsui; Henrikki Santti; Tomas L Griebling; Alexey E Pryalukhin; Jarno Riikonen; Riikka M Tähtinen; Camille P Vaughan; Theodore M Johnson; Diane Heels-Ansdell; Gordon H Guyatt; Kari A O Tikkinen Journal: J Urol Date: 2019-07-26 Impact factor: 7.450
Authors: Varant Kupelian; Mary P Fitzgerald; Steven A Kaplan; Jens Peter Norgaard; Gretchen R Chiu; Raymond C Rosen Journal: J Urol Date: 2010-12-18 Impact factor: 7.450