urovestВестник урологииUrology Herald2308-6424Rostov State Medical University10.21886/2308-6424-2017-5-2-60-68urovest-151Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWS ARTICLEСОВРЕМЕННЫЙ ВЗГЛЯД НА НОКТУРИЮ У ПАЦИЕНТОВ С ДОБРОКАЧЕСТВЕННОЙ ГИПЕРПЛАЗИЕЙ ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫMODERN VIEW OF NOCTURIA IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIAhttps://orcid.org/0000-0003-2733-0619ЕфремовМ. Е.ЕfremovМ. Е.

врач-уролог ГБУЗ «Научно-исследовательский институт – Краевая клиническая больница №1 им. проф. С.В. Очаповского» МЗ Краснодарского края

 

 

efremov.uro@yandex.ruhttps://orcid.org/0000-0001-8335-2578МедведевВ. Л.МedvedevВ. L.

доктор медицинских наук, профессор, заведующий кафедрой урологии ФГБОУ ВО «Кубанский государственный медицинский университет» МЗ РФ; заместитель главного врача по урологии, руководитель уронефрологического центра ГБУЗ «Научно-исследовательский институт – Краевая клиническая больница № 1 им. проф. С.В. Очаповского» МЗ Краснодарского края

 

 

 

medvedev_vl@mail.ruhttps://orcid.org/0000-0002-2358-6302ШорниковП. В.ShornikovP. V.

кандидат медицинских наук, ассистент кафедры урологии ФГБОУ ВО «Кубанский государственный медицинский университет» МЗ РФ, заведующий отделением функциональной диагностики №2 ГБУЗ «Научно-исследовательский институт – Краевая клиническая больница № 1 им. проф. С.В. Очаповского» МЗ Краснодарского края

shpvkr@mail.ruГБУЗ «Научно-исследовательский институт – Краевая клиническая больница № 1 им. проф. С.В. Очаповского» МЗ Краснодарского краяРоссияResearch Institution - Regional Clinical Hospital №l of prof. S.V. OchapovskogoRussian FederationГБУЗ «Научно-исследовательский институт – Краевая клиническая больница № 1 им. проф. С.В. Очаповского» МЗ Краснодарского края; ФГБОУ ВО «Кубанский государственный медицинский университет» МЗ РФРоссияResearch Institution - Regional Clinical Hospital №l of prof. S.V. Ochapovskogo; Kuban State Medical UniversityRussian Federation201709072017526068Copyright © Ефремов М.Е., Медведев В.Л., Шорников П.В., 20172017Ефремов М.Е., Медведев В.Л., Шорников П.В.Еfremov М.Е., Мedvedev В.L., Shornikov P.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.urovest.ru/jour/article/view/151

Ноктурия традиционно считается преобладающим симптомом нижних мочевыводящих путей у пациентов с доброкачественной гиперплазией предстательной железы (ДГПЖ). Урологи и врачи общей практики становятся все более осведомленными и заинтересованы в определении вида ноктурии, о чем свидетельствуют крупные эпидемиологические исследования. Ноктурия является распространенным симптомом многих состояний и встречается у пациентов с разными заболеваниями. Этиология ноктурии является многофакторной. Современная классификация ноктурии базируется на данных дневников мочеиспускания и классифицируется следующим образом: суточная полиурия, ночная полиурия, сниженная ёмкость мочевого пузыря, расстройства сна и расстройства циркадного ритма. Суточная полиурия у взрослых определяется как объемом мочеобразования более 2,8 л в течение 24 ч. Значение объема мочеобразования 2,8 л в сутки применимо к человеку с массой тела 70 кг и скоростью диуреза более 40 мл/кг/24ч. Дневник мочеиспускания является важным инструментом оценки ноктурии, который может облегчить точную идентификацию потенциальных множественных причин у пациента, обеспечивая доказательства того, что этиология никтурии может быть отнесена к одной или комбинации причин: нарушений сна, ночной полиурии, суточная полиурия или уменьшенной емкости мочевого пузыря. Расстройства циркадных ритмов в патофизиологии ноктурии заслуживает дальнейшего внимания.

Nocturia, awaking from sleep to void, has a negative impact on health and well-being. Nocturia traditionally has been regarded as a predominantly male condition, but it is just as prevalent in women as in men. Urologists and general practitioners are becoming increasingly aware of and interested in nocturia, as indicated by the recent increase in large epidemiologic studies and analyses and by initiatives such as the Nocturia Think Tank and The Consensus Statement from the Interdisciplinary Conference on Nocturia. Nocturia is a common symptom of many conditions and is encountered in patients presenting to services across different medical specialities and health disciplines. The causal pathway of nocturia is multi-factorial and differs between patients. There is currently no symptom-specific clinical algorithm for all-cause diagnosis of nocturia. A thorough history and assessment of number and times of voids, void volume, and fluid intake is essential for determining the etiology of a patient’s nocturia. With data obtained from the frequency-volume chart (FVC), which is used to collect quantitative voiding data, a patient’s nocturia may be classified as global polyuria, nocturnal polyuria, reduced bladder capacity, or a combination of these categories. Global polyuria is defined as 24-hr urinary output that exceeds 40 ml/kg body weight and results in increased 24-hr urinary frequency. Nocturia is a complex multifactorial condition that requires careful evaluation for appropriate diagnosis. The FVC is an essential evaluation tool that can facilitate accurate identification of the potential multiple causes of nocturia in an individual patient, providing evidence by which the etiology of nocturia can be categorized into one or a combination of categories of sleep disorders, nocturnal polyuria, global polyuria, and reduced bladder capacity. The role of the circadian clock in the pathophysiology of nocturia deserves further attention.

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The authors declare that there are no conflicts of interest present.