排尿日志-临床分析及应用.ppt

排尿日誌-臨床分析及應用 花蓮佛教慈濟綜合醫院 泌尿科 郭漢崇 醫師 Voiding Diary – Analysis and Clinical Application Hann-Chorng Kuo Department of Urology Buddhist Tzu Chi General Hospital Lower urinary tract symptoms in geriatric population LUTS are common in elderly Nocturia is the third most bothersome LUTS Prevalence of nocturia increases to 80% in patients aged over 80 years Nocturia is one of the most common causes of disturbed sleep pattern Voiding Diary Assessment of frequency, urgency, and nocturia in patients with LUTS Record voided urine volume and total daily urine volume Calculate nocturnal urine volume Investigate causes for frequency and polyuria Assessment of Voiding Diary Water intake medication Total urine production Voided volume (functional bladder capacity usual voided volume) Frequency and nocturia pattern Water Intake and Medication Normal water intake 100ml per hour 2400ml per day Excessive water intake - polydipsia Medication: diuretics, antimuscarinics Total urine production Normal urine production 2800ml per day Daytime polyuria Nocturnal polyuria Diurnal polyuria Voided urine volume (Functional bladder capacity) Normal FBC voided volume Reduced bladder capacity (FBC voided volume 350ml) Increased bladder sensation in day or night (FBC 350ml, usual voided volume 350ml) Frequency urgency symptoms Daytime frequency/ urgency Nighttime frequency/ urgency Diurnal frequency/ urgency Urge incontinence Nocturia A result of excessive amount of urine production at night Noctural polyuria 35% daily urine Abnormal lower urinary tract function A combination of two etiologies Etiologies of Nocturia Detrusor overactivity Increased bladder sensation Bladder outlet obstruction Nocturnal polyuria Small bladder capacity Impact of Nocturia on the Elderly Elderly patients are likely to be exposed to serious health risks Nocturia causes fatigue due to sleep deprivation Increase chance of traumatic injury through falling from 10 to 21% with 2 voids per night Nocturn