Pathogenesis, complex diagnosis and pathogenetic therapy of nocturia


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Abstract

In a review article the pathogenesis, clinical diagnostic and pharmacological aspects of the symptoms of night urination (nocturia), based on the results of modern research evidence and their own clinical and scientific data are discussed. Nocturia is a universal phenomenon of the age, gender devoid of color, and its frequency in both men and women has been steadily progressing with age. Given the lack of clinical interest in our country to nocturia, the authors propose a proprietary algorithm of integrated diagnostics the causes of nocturia, which maximizes early to identify the majority of its pathogenetic mechanisms in order to subsequently each was fully corrected the relevant pathogenetic pharmacotherapy. Common pathogenetic mechanisms of its development are 24-hour polyuria, nocturnal polyuria associated with deficiency of vasopressin, as well as reducing the reservoir capacity of the bladder and sleep disturbance, which should identify every patient with nocturia. However, the available literature data indicate that, in addition to the shortfall of vasopressin its corresponding synthetic analogues, effective pharmacotherapeutic options in relation to nocturia does not exist today. But, if we consider it from the standpoint of nocturia modern multifactor pathogenesis and, above all, due to biological aging, it is possible to discuss some of the promising anti-aging therapy therapeutic measures that, among other things, could have a positive impact on the clinical course of nocturia and reduce its negative implications for human aging. These forward-looking group of drugs (PDE-5 type inhibitors, insulin sensitisers, hormone D drugs, sex hormones) with potentially pathogenic effect in relation to nocturia are also described in the article for informational purposes, as their evidence base in relation to nocturia can not yet be regarded as sufficient.

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