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The principal diagnostic tool for nocturia is the voiding bladder diary. Based on information recorded in the diary, a physician can classify the patient as having global polyuria, nocturnal polyuria, or bladder storage problems. A voiding bladder diary should record: [citation needed] number of voids; timing of voids; volume voided
Bladder training is a behavioral therapy aimed at improving bladder control and managing urinary incontinence. It is a non-invasive intervention commonly employed for various types of incontinence, including urge incontinence, stress incontinence, and mixed incontinence.
A voiding diary in the form of a frequency volume chart records voided volume along with the time of each micturition for at least 24 hours. The frequency volume chart is enough for patients with complaints of nocturia and frequency only. If other symptoms are also present then a detailed bladder diary must be maintained.
Urination, or voiding, is a complex activity. The bladder is a balloon-like muscle that lies in the lowest part of the abdomen. The bladder stores urine and then releases it through the urethra, which is the canal that carries urine to the outside of the body. Controlling this activity involves nerves, muscles, the spinal cord and the brain.
Urogynecology is a sub-specialty of Gynecology, and in some countries is also known as Female Pelvic Medicine and Reconstructive Surgery. A urogynecologist manages clinical problems associated with dysfunction of the pelvic floor and bladder. Pelvic floor disorders affect the bladder, reproductive organs, and bowels.
A voiding diary and/or a measured voided volume gives an estimate of bladder capacity. A free-flow uroflowmetric examination gives additional information about flow rate, voided time and volume. A cystometrogram will evaluate detrusor over-activity, bladder compliance, bladder capacity, and abdominal (Valsalva) leak pressure.
Neurostimulation treatment of adult enuresis may be considered prior to pursuing surgical methods. For adult enuresis, sacral nerve stimulation can be administered to decrease bladder muscle activity so that the bladder muscles are not constantly in a contracted state to help improve enuresis symptoms. [28] [29]
Injections of botulinum toxin into the bladder is another option. [3] Urinary catheters or surgery are generally not recommended. [3] A diary to track problems can help determine whether treatments are working. [3] Overactive bladder is estimated to occur in 7–27% of men and 9–43% of women. [1] It becomes more common with age. [1]
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