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walter.artibani@univr.it

Nocturia v escica , prostata o sintomo sistemico ?. walter.artibani@univr.it. LOWER URINARY TRACT SYMPTOMS (LUTS). STORAGE SYMPTOMS urgency, frequency, nocturia incontinence. VOIDING SYMPTOMS poor stream, hesitancy. POSTMICTURITION SYMPTOMS postmicturition dribble

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walter.artibani@univr.it

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  1. Nocturia vescica, prostata o sintomo sistemico ? walter.artibani@univr.it

  2. LOWER URINARY TRACT SYMPTOMS (LUTS) STORAGE SYMPTOMS urgency, frequency, nocturia incontinence VOIDING SYMPTOMS poor stream, hesitancy POSTMICTURITION SYMPTOMS postmicturition dribble sensation of incomplete emptying

  3. ICS, 2002 “The complaint that the individual has to wake at night 1 or more times to void” Report from the standardization sub-committee ICS, 2003 “ The number of voids are recorded during a night’s sleep : each void is preceeded and followed by sleep ICS definition refers to nocturia as a complaint rather than a clinical important condition The word “night” should be replaced by sleep time Definition Abrams P et al. Urology 61(1), 2003 Nocturia THINK TANK and consensus statement from interdisciplinary conference on nocturia Weiss P BJU Int 108 : 6, 2011

  4. Prevalence • Men aged 20–40 years: 2–17% • Women aged 20–40 years: 4–18% • Men aged > 70 years: 29–59% • Women aged > 70 years: 28–62% Cornu JN EurUrol 62 : 877, 2012

  5. Tikkinen et al. Eur Urol 57(3) 488-496, 2010

  6. Nocturia QoLand economic impact • Diurnal fatigue • Decreased concentration • Lower performance at work • Accidents (fractures...) • Quality of sleep of the partner • ≥ 3 voids /night it is associated • with higher total medical costs Cornu JN EurUrol 62 : 877, 2012 Nakagawa H JUrol 183 : 1, 2010

  7. Definitions van Kerrebroeck et al. Neurology and Urodynamics 21:179-183, 2002

  8. Definitions ”Nocturia occurs when the nocturnal urine volume exceeds the maximum voided volume that reflects the functional bladder capacity..." Dani H Nature Reviews 13 : 573, 2016

  9. Classification ICI, 2013

  10. No abnormalities on FVC

  11. 24-h urine volume > 40 ml/kg

  12. NPI > 20-33%

  13. NBCi > 0

  14. Classification Cornu JN EurUrol 62 : 877, 2012

  15. Classification ICI, 2013

  16. Nocturia sintomo isolato concausa sistemica nota Nocturia sintomo isolato senza causa sitemica nota

  17. Nocturia insieme a sintomi minzionali

  18. Nocturia come sintomo SISTEMICO e non di organo

  19. CIRCUIT 2: BLADDER SENSORY INFORMATION & PREPARATION OF MOTOR RESPONSES CIRCUIT 1: VOID-NO VOID DECISION WHITE MATTER DISEASE CIRCUIT 3: ENVIRONMENT RECOGNITION EMOTIONAL STATE

  20. Urologo funzionale sempre più specialista globale e non di organo

  21. Nocturia vescica, prostata sintomo sistemico ? walter.artibani@univr.it

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