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Query: UMLS:C0677481 (urinary frequency)
 1,126 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aging process, behavioural habits and a multitude of pathological conditions are the main contributors to the development of nocturia in the elderly. Age-related physiological changes can alter the regular pattern of urine excretion and lead to increased nocturnal frequency of voiding. In addition, aging is associated with anatomical and physiological changes of the urinary tract itself that predispose to increased urinary frequency without affecting urine volume. Several urinary and extra-urinary tract conditions may have nocturia as a prominent symptom. These conditions can be grouped as those associated with bladder overactivity, bladder outlet obstruction, bladder hypotonicity and an increased urine volume. A detailed assessment that gathers clues from the medical history, physical examination and laboratory is of utmost importance in identifying the specific causes. Overactive bladder can be idiopathic or associated with different triggers such as UTI, bladder stones, bladder tumours and CNS diseases that disrupt the normal inhibitory signals to the bladder. It may be cured by the successful elimination of the trigger conditions. Therapeutic modalities include behavioural therapies with scheduled voiding, anticholinergic drugs and in women the use of transvaginal electrical stimulation. Benign prostatic hyperplasia is the most common cause of bladder outlet obstruction in men. Different drug classes (e.g. peripheral alpha-adrenoceptor blockers and 5 alpha-reductase inhibitors) are now available for the treatment of mild to moderate symptoms. Surgery is reserved for patients with severe symptoms or with complications, with new and less invasive surgical techniques being preferred. Bladder hypotonicity is usually caused by peripheral neuropathies, spinal cord lesions and the indiscriminate use of drugs with anticholinergic actions. Treatment involves discontinuation of implicated drugs, short term use of cholinergic drugs and urinary catheterisation. Increased urine volumes and nocturia are frequently seen in hyperosmolar and oedematous states. Excessive ingestion of fluids, caffeinated or alcoholic beverages are habits that commonly produce nocturia. Although more definitive studies are awaited, low dose loop diuretics given a few hours prior to bedtime and desmopressin nasal spray or tablets may be useful alternatives for the control of nocturic symptoms in elderly patients with nocturnal polyuria syndrome. Whenever nocturia is present, clinicians should try to identify its causes by means of a thorough history, physical examination and pertinent complimentary tests. Once the specific cause or causes are found, most cases can be satisfactorily managed with behavioural, pharmacological or surgical therapies.
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PMID:Treatment of nocturia in the elderly. 1064 54

The results of vulvoplasty were evaluated in 34 dogs that underwent surgery at the University of Wisconsin Veterinary Medical Teaching Hospital between 1987 and 1999. Case records were evaluated, and clients were interviewed by telephone. The most common clinical signs of a juvenile or recessed vulva at initial examination were perivulvar dermatitis in 59% (20/34) of dogs and urinary incontinence and chronic urinary tract infection (UTI), each present in 56% (19/34) of dogs. Other common complaints included pollakiuria, irritation, and vaginitis. Most dogs developed clinical signs before 1 year of age. All dogs except one bichon frise were medium to giant breeds, suggesting that vulvar conformation may be related to growth rate or body conformation; prior ovariohysterectomy did not appear to be an influencing factor. Eighty-two percent of owners rated the outcome of the surgery as at least satisfactory. The incidence of urinary incontinence was reduced by vulvoplasty; however, it remained the most common residual sign after surgery, suggesting a multifactorial etiology. The incidences of UTI, vaginitis, and external irritation were greatly reduced after surgery.
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PMID:Results of vulvoplasty for treatment of recessed vulva in dogs. 1180 21

Interstitial cystitis (IC) is a chronic disorder of unknown etiology that affects the lower urinary tract of up to 500,000 women and men in the United States. It is characterized by bladder and pelvic pain that varies from moderate discomfort to severe, debilitating pain and related lower urinary tract symptoms including nocturia, diurnal urinary frequency, and urgency. Because the symptoms of IC superficially resemble a urinary tract infection, it is often misdiagnosed and may remain so for months or even years. This article discusses the clinical manifestations of IC, including its differentiation from acute or recurring bacterial cystitis. Options for managing this significant and often debilitating voiding dysfunction are also discussed.
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PMID:Interstitial cystitis: a guide to recognition, evaluation, and management for nurse practitioners. 1190 18

One hundred forty-four children with a clinical diagnosis of overactive bladder were observed for a mean of 3.15 +/- 1.92 years. Initial management consisted of a behavioral modification program that included increased fluid intake, a timed voiding schedule and, if applicable, treatment of constipation. Those who failed to improve with the preceding intervention within 10 days to 2 weeks received an anticholinergic medication. Follow-up information was obtained by telephone. Caretakers and/or patients were asked a standard set of questions. The outcome with respect to urinary urgency, urinary frequency, daytime incontinence, posturing and urinary tract infections was recorded. After an average follow-up period of 3 years, 68 (47.2%) of the 144 children recovered from all symptoms of overactive bladder and 61 (42.4%) had decreased symptoms. Fifteen of the children, or 10.4%, still had all of the symptoms originally associated with overactive bladder. Children who had posturing as one of their symptoms had a significantly increased risk of urinary tract infection.
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PMID:Outcome of overactive bladder in children. 1292 58

Four dogs with ureteral fibroepithelial polyps, ranging from 9-12 years of age, are presented in this report. The patients presented with urinary incontinence, urinary tract infection, and/or polydypsia and pollakiuria. All dogs were intact at the time of diagnosis or for the majority of their lives and three were male. Various diagnostic procedures were performed including ultrasonography, contrast radiography, and nuclear scintigraphy. Not all procedures were performed in all patients. Findings included ureteral dilation proximal to the level of an intraluminal mass and ipsilateral hydronephrosis. Unilateral ureteronephrectomy was performed in three dogs with masses in the proximal ureter; ureteral resection and anastamosis was performed in the remaining patient with a mass located in the distal ureter. The same pathologist (RAP) reviewed all four lesions. The lesions appeared polypoid and were attached to the ureteral wall by a thin stalk. Histopathologically, they contained a superficial layer of well-differentiated transitional epithelial cells overlying a prominent fibrovascular stroma with a mild (three dogs) or marked (one dog) degree of lymphoplasmacytic inflammation. This disease may represent a benign neoplasm or a chronic inflammatory reaction and has a good prognosis with surgical removal. Its histopathological characteristics, higher incidence in males, and location more commonly within the upper third of the ureter is remarkably similar to the disease in humans.
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PMID:Ureteral fibroepithelial polyps in four dogs. 1293 61

Several generalized symptoms in acute lower urinary tract infection (UTI) have previously been identified in a qualitative study. The aim of the present study was to explore the frequency and distribution of generalized symptoms in adult women with acute uncomplicated lower UTI in general practice. A total of 398 women aged 18-87 years consulting for acute dysuria and/or urinary frequency were enrolled in an observational study and filled in a structured symptom questionnaire. A total of 252 of these had bacteriuria (>or= 10(5) uropathogens/mL). Generalized symptoms occurred frequently: feeling unwell 68%, week and tired 67%, irritable and restless 53%, and hot 52%. Other symptoms were voiding-related symptoms (dysuria 90%, urinary frequency 93%, urge 80%) and local, constant symptoms (pressure in the genital area 73%, suprapubic discomfort 68%). Factor analysis revealed 2 main components of cystitic symptoms: "feeling out of sorts" (generalized symptoms) predominantly found among women aged 50-65 years, and the "distressed bladder" (voiding-related and local, constant symptoms) most often in the group aged 18-35 years. No differences in frequency or degree of symptoms were related to the presence of bacteriuria. In conclusion, generalized symptoms of feeling out of sorts are frequent in adult women with acute uncomplicated lower UTI, and equally frequent in all ages whether the patient shows bacteriuria or not.
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PMID:Generalized symptoms in adult women with acute uncomplicated lower urinary tract infection: an observational study. 1460 Jun 38

An 8-year-old, female spayed miniature schnauzer was presented for pollakiuria and gross hematuria. Infection-induced struvite urolithiasis with concurrent bacterial urinary tract infection was diagnosed. The treatment is described, followed by a brief discussion of struvite stones and their medical management.
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PMID:Dissolution of infection-induced struvite bladder stones by using a noncalculolytic diet and antibiotic therapy. 1553 83

Overactive bladder (OAB) is a debilitating condition characterised by an urgent need to urinate (urgency), often with urinary frequency and, in some cases, urgency incontinence and nocturnal frequency. Patients often adopt complex adaptive behaviours to cope with their symptoms as OAB can compromise all dimensions of a patient's quality of life. Most OAB patients present initially to their primary care physician. Diagnosis is based on presenting symptomatology and does not require any invasive tests. Direct questioning about symptoms is important in achieving a differential diagnosis. The most common condition to be considered when working towards a differential diagnosis is a urinary tract infection (UTI). However, some physicians have expressed concerns about identifying the small number of cases where bladder cancer is a potential underlying aetiology for the symptoms of OAB. In this review, we examine the prevalence and patient profiles for these bladder conditions and their presenting symptomatology. We also review tests that may be recommended to exclude a diagnosis of UTI or bladder cancer and present a diagnostic algorithm suitable for office-based primary care practice.
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PMID:Overactive bladder: achieving a differential diagnosis from other lower urinary tract conditions. 1596 11

Once thought to be rare, interstitial cystitis (IC) is now believed to have a markedly higher prevalence. This potentially devastating disease is also known as painful bladder syndrome (PBS) and can significantly impact quality of life. It is diagnosed by its symptoms, as there are no proven pathological findings. Unfortunately, the symptoms of IC/PBS overlap those of other common disease states such as overactive bladder, endometriosis, urinary tract infection, and prostatitis, which complicates the differential diagnosis. Understanding the presenting symptoms of urinary frequency, urinary urgency, and pelvic pain in the presence of otherwise normal findings can enhance primary care providers' ability to appropriately identify the disease. Early identification may allow initiation of therapy or referral before the disease becomes refractory to standard treatment, which typically includes behavioral therapy and possibly multimodal drug therapy.
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PMID:Interstitial cystitis/painful bladder syndrome: symptom recognition is key to early identification, treatment. 1754 32

Interstitial cystitis/painful bladder syndrome (IC/PBS) is characterized by urinary frequency, urgency, and pelvic pain in the absence of any other identifiable pathology. Initial identification of IC/PBS is challenging, as patients may have a range of symptoms that overlap with other disorders, including urinary tract infection (UTI). These patients may be treated empirically with antibiotics; however, many patients with such symptoms are actually culture negative and are later diagnosed with IC/PBS. This review describes the importance of recognizing the symptom overlap between IC/PBS and UTI and focuses on approaches to the diagnosis and management of IC/PBS. Physicians can improve patient care by considering IC/PBS early in the differential diagnosis.
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PMID:Interstitial cystitis/painful bladder syndrome: appropriate diagnosis and management. 1793 71


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