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Pollakiuria : Definition, Symptoms, Causes, Tests, and Preventive Measure

Saturday, September 29th 2012. | General

Pollakiuria Definition

Pollakiuria is a frequent urge to urinate.

A more frequent urination pollakiuria is an increase in the frequency of urination without increased diuresis (urine total volume issued in 24 hours).

It is estimated that: 

- A daytime urinary frequency if we urinate at least every two hours during the day, and

- A nocturia when we must rise at least twice a night to urinate.

The causes of frequent urination are numerous, depending on the sex and age. The context in which it occurs often directs the physician’s diagnosis.

Pollakiuria picture

The most common causes are urinary tract infections, urinary incontinence, benign prostatic hyperplasia and urolithiasis.

How’s it going?

The bladder is both a low pressure reservoir which is filled passively urine (urine produced by the kidneys through the ureters it arrives) and a muscle can contract during urination.

To exit the bladder urine must pass a system usually contracted, consisting of two circular muscles surrounding the urethra sphincter smooth (the neck of the bladder) and the striated sphincter.

When the bladder fills a nervous tone (sympathetic tone) is exerted, on the one hand, maintain the contraction of smooth and striated sphincter of the bladder while inhibiting the other hand, the bladder contraction.

For urination is possible that parasympathetic tone must be exercised, which will both lead to the release and contraction of the sphincter of the bladder. It is the synergy detrusor-sphincter. When the pressure inside the bladder exceeds that of the sphincter, voiding occurs.

The sphincters are responsible for continence but urination is under nervous control (sympathetic and parasympathetic nervous system in particular). This explains why the OAB treatments that decrease parasympathetic activity (drugs called anticholinergics, atropine) improve symptoms by reducing bladder contractions and urinary frequency. Conversely, treatments that reduce the activity of the sphincters (medicines called alpha-blockers) improve bladder emptying.

Decreased bladder capacity may be real anatomical

- By reducing the volume of the bladder (“small bladder” after radiotherapy due to interstitial cystitis, a tuberculosis …;

- Persistence of a volume by “useless” in the bladder, which is to say that even during urination part of the urine remains in the bladder (residual urine) or when the bladder muscle tonic is not enough to achieve complete emptying of the bladder during urination (bladder hypotonia).

Pollakiuria can also be functional. The frequent urination is then due to stimulation of the bladder with bladder contractions inadequate: infectious disease (including cystitis) causes variables (irritative, neurological, psychogenic, behavioral).

Pollakiuria Symptoms

The characteristic symptom is urinary frequency increased urination, or in the day (interval of less than 2 hours between voiding) or night (at least two urination at night. It is awakened by the urge urinating. Insomnia during which we will urinate several times is not strictly speaking a pollakiuria.

There may be other urological symptoms depending on the cause of frequent urination:

  • Burning on urination,
  • Urinary urgency (must rush to urinate)
  • Leakage on effort, dysuria (difficulty urinating), pyuria (urine is turbid)
  • Hematuria (urine is pink, brown or red or urine dipstick reveals traces of blood in the urine appeared normal color).

Pollakiuria Causes

We distinguish causes anatomical and functional causes.

We must eliminate the “false pollakiuries” which are actually due to excess urine production occurs in certain disease: it is a hyper diuresis found when potomania, alcoholism, diuretic, nephrogenic diabetes, nephropathy loss salt, poorly controlled diabetes, … In these cases, the voided volume of at least 3 liters per day and is called polyuria.

It can also be a preventive behavior for fear of leaks urinary incontinence, such as postmenopausal women with uterine prolapse or a man with benign prostate.

Anatomical causes

  • Small bladder radiation (after radiotherapy).
  • Small bladder due to tuberculosis, bilharzia, cancer, interstitial cystitis …
  • Post-voiding residue (incomplete emptying).
  • Hypotonia bladder (bladder contractions inadequate).

Functional causes

Pollakiuria Tests

The doctor will ask questions likely to move towards the cause of frequent urination and make a general clinical examination, including pelvic examination includes a review urogenital and neurological examination.

Some tests will be done according to the context, sex and initial assessment. They are guided by the suspected etiologies: uroflowmetry (prostatic obstruction?), Cystoscopy (bladder cancer?)

Urodynamic assessment, usually performed by a urologist, may be considered in a second time with no obvious cause urinary frequency. We then search hyper-reflexive bladder and detrusor instability.

Pollakiuria in Children

In children, urinary frequency may simply be a symptom of immaturity or overactive bladder.

Before the normal age of acquisition of cleanliness, we speak of immaturity bladder and unstable bladder then.

The bladder is normal immaturity as overactive bladder is not.However, the instability is common is bladder usually improves with age.

An assessment of renal function is often performed to rule out kidney disease.

Pollakiuria In the elderly

Must eliminate incomplete voiding (bladder by hypotonia and / or prostatic obstruction in men).

Ultrasound can also highlight an abnormal bladder (bladder control, bladder cancer, bladder stones, etc.)..

When the night is only pollakiuria (and other causes have been ruled out, including prostate adenoma in men over 50 years), then consider carefully the context for inappropriate behavior can promote urinary frequency.

In contrast, urinary frequency, which is also daytime fears onset of neurological disease (perturbation centers activators and inhibitors of urination) or treatable cause bladder (cystoscopy in search of a polyp, d a carcinoma in situ ).

Pollakiuria Preventive Measure

Pollakiuria is a symptom that accompanies many diseases. It is therefore the treatment of the cause is the treatment.

Four simple steps to reduce the inconvenience caused by urinary frequency and contribute to improve the comfort of life :

  • Fluid restriction (about 1.5 l / j): drink less especially at night, avoiding or reducing coffee and alcohol
  • Limitation of the duration of sleep (to increase its depth);
  • Perform regular physical exercises (in moderate doses);
  • Warm his bed (water bottle in winter).
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