Evaluation of the occurrence and diagnose definitions for nocturnal polyuria in spinal cord injured patients during rehabilitation

Viaene, Annick; Denys, Marie‐Astrid; Goessaert, An-Sofie; Claeys, Jana; Raes, Ann; Roggeman, Saskia

doi:10.23736/s1973-9087.17.04851-1

Cited by 12 publications

(3 citation statements)

References 27 publications

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“…Other definitions are available, 16 but the most appropriate definition of NP is still the subject of much discussion. 17,18 However, the definition of NP is not the scope of this document.…”

Section: The Lower Urinary Tract Packagementioning

confidence: 99%

International Continence Society consensus on the diagnosis and treatment of nocturia

Everaert

Hervé

Bosch

et al. 2019

Neurourology and Urodynamics

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Introduction Patients with nocturia have to face many hurdles before being diagnosed and treated properly. The aim of this paper is to: summarize the nocturia patient pathway, explore how nocturia is diagnosed and treated in the real world and use the Delphi method to develop a practical algorithm with a focus on what steps need to be taken before prescribing desmopressin. Methods Evidence comes from existing guidelines (Google, PubMed), International Consultation on Incontinence‐Research Society (ICI‐RS) 2017, prescribing information and a Delphi panel (3 rounds). The International Continence Society initiated this study, the authors represent the ICI‐RS, European Association of Urology, and Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU). Results Diagnostic packages: consensus on, history taking for all causalities, intake diary (fluid, food) and bladder diary, not for its duration. Pelvic (women) or rectal (men) examination, prostate‐specific antigen, serum sodium check (SSC), renal function, endocrine screening: when judged necessary. Timing or empty stomach when SSC is not important. Therapeutic packages: the safe candidates for desmopressin can be phenotyped as no polydipsia, heart/kidney failure, severe leg edema or obstructive sleep apnea syndrome. Lifestyle interventions may be useful. Initiating desmopressin: risk management consensus on three clinical pictures. Follow‐up of desmopressin therapy: there was consensus on SSC day 3 to 7, and at 1 month. Stop therapy if SSC is <130 mmol/L regardless of symptoms. Stop if SSC is 130 to 135 mmol/L with symptoms of hyponatremia. Conclusion A summary of the nocturia patient pathway across different medical specialists is useful in the visualization and phenotyping of patients for diagnosis and therapy. By summarizing basic knowledge of desmopressin, we aim to ease its initiation and shorten the patient journey for nocturia.

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Section: The Lower Urinary Tract Packagementioning

confidence: 99%

International Continence Society consensus on the diagnosis and treatment of nocturia

Everaert

Hervé

Bosch

et al. 2019

Neurourology and Urodynamics

Self Cite

109

104

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“… 1–5 The presence of SCI-induced polyuria increases the number of daily catheterizations, especially at night (disrupting sleep), which raises the risk of developing genitourinary infections, a leading cause for hospitalizations in the SCI population. 6 SCI-induced polyuria has been shown to be present in both pre-clinical SCI animal models and clinically, 7–10 regardless of severity 7 or completeness 11 of injury.…”

Section: Introductionmentioning

confidence: 99%

Effect of T3 Spinal Contusion Injury on Upper Urinary Tract Function

Gumbel

Hubscher

2022

Neurotrauma Reports

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“…Due to the fact that these patients are in a wheelchair during the day, their legs become progressively oedematous towards the evening. When these patients lie down in bed with their legs up during the night, the oedema progressively decreases towards the morning . As a result of this natural drainage mechanism of intercellular fluid, urine production during the night increases and can cause nocturnal polyuria (NP) .…”

Section: Introductionmentioning

confidence: 99%

Conservative treatment for leg oedema and the effect on nocturnal polyuria in patients with spinal cord injury

et al. 2019

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Objectives To evaluate the possible influence of non‐pharmacological interventions, such as compressive bandages and intermittent pneumatic compression (IPC), on leg oedema and nocturnal polyuria (NP), and the possible interrelation between both pathologies in patients with spinal cord injury (SCI), as patients with SCI often have leg oedema and during the night the oedema decreases as a result of natural drainage mechanisms that can cause NP. Patients and Methods Patients with SCI who followed their first rehabilitation after their SCI with bilateral leg oedema and/or with as much or a larger urine volume at night as during the day. The patients were all wheelchair users and followed the rehabilitation programme daily for 3 weeks. In all, 24 patients, aged between 21 and 63 years, were selected for participation in the 3‐week rehabilitation programme. During the first week, baseline data were collected. During the second week, IPC was executed from the moment the patient went to lie down. During the third week, the patients wore multilayer compressive bandages. Leg circumference was measured in the morning before sitting up and at the moment they went to lie down in bed. During each study week, a daily frequency–volume chart (24 h) was completed. Results The leg volume of both legs was significantly different between the morning and evening (right leg F = 103.90, P < 0.001; left leg F = 100.77, P < 0.001) and between the three treatments (right F = 9.70, P < 0.001; left F = 9.66, P < 0.001). There was a significant difference between the compressive bandages and the baseline period (right and left leg, both P < 0.001) and between the compressive bandages and IPC (right leg P = 0.009 and left leg P = 0.015). There was no significant difference between IPC and the baseline. When no treatment or IPC was used, urine production was significantly higher during the bed‐rest period. The urine production was significantly lower comparing the use of compressive bandages to baseline and IPC, during bed rest (P = 0.009) and during sleep (P < 0.001). There was a significant decrease in absolute voided volume at night with the compressive bandages as treatment (P < 0.001). There was a significant positive association between the leg volume change during the day and the urine‐production ratio, 100 mL increase in leg volume was associated with 8% increase in the log‐transformed urine‐production ratio. Conclusion There are alternative treatment options for patients with SCI who have oedema or NP. Oedema formation and urine production appear to be related to each other. Therefore, the use of compressive bandages was shown to be a valuable treatment option to improve both leg oedema and NP.

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Evaluation of the occurrence and diagnose definitions for nocturnal polyuria in spinal cord injured patients during rehabilitation

Cited by 12 publications

References 27 publications

International Continence Society consensus on the diagnosis and treatment of nocturia

International Continence Society consensus on the diagnosis and treatment of nocturia

Effect of T3 Spinal Contusion Injury on Upper Urinary Tract Function

Conservative treatment for leg oedema and the effect on nocturnal polyuria in patients with spinal cord injury

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