Nocturnal polyuria after lumbar disc herniation surgery

A male patient with seventy-six years old, frequent urination at night, lassitude, aversion to cold, feeling tired easily on exertion, soreness and weakness in the lumbar region, dark and purplish tongue with white coating, deep, thread and rapid pulse. Diagnosis: nocturnal polyuria. Syndrome differentiation in traditional Chinese medicine: kidney yang deficiency. In treatment, the Du-moxibustion(moxibustion along the Governor vessel) was adopted in the lumbosacral region. A number of cross marks were marked along Zhōngshū(中枢GV 7) to Yaoshù(腰俞 GV 2). Herbal powder for the Du-moxibustion was put evenly and straightly from GV 7 to GV 2 along the cross marks. The mulberry bark paper was put flatly over the treating region with the folded midline of the paper matching the powder line and the ginger paste was placed on the paper and flatted with the tongue depressor as a trapezium. A groove was pressed on the ginger paste, And moxa was put inside. The upper, middle and lower sites of the moxa were ignited for moxibustion,when the moxa was burnt out then new moxa was replaced. Totally,the moxa was changed 3 times in one treatment. The treatment was given once a week, and 4 treatments as one course. After 2-course Du-moxibustion, the frequency of nocturnal urination was 0-1 time,0-350 mL a night. The patient had lassitude and fatigue occasionally and had no aversion to cold. The treatment was given once every two weeks on the lumbosacral region until the urine frequency was normal at night. The Du-moxibustion improves in kidney yang deficiency, kidney qi deficiency, post-operative body weakness and the deficiency cold of the lower Jiao. This therapy warms the meridian, promotes qi and blood circulation, shortens the recovery time of the normal circulation of the cerebrospinal fluid and nourishes cauda equina as well as alleviates the pressure to cauda equina due to edema. This therapy effectively treats nocturnal polyuria of kidney yang deficiency after lumbar disc herniation surgery.

Desmopressin for the treatment of female storage lower urinary tract symptoms

Female storage lower urinary tract symptoms are prevalent and bothersome. They are usually attributed to an overactive bladder and treated with antimusca-rinics. Nevertheless, failure of conventional treatment to alleviate nocturia in particular and epidemiological data suggesting that nocturnal polyuria is the only or a contributing factor to nocturia, has attracted interest in decreasing nighttime urine production as a method of managing nocturia. A reduction in urine production could also, at least temporarily, delay daytime stor-age symptoms by delaying bladder filling. Therefore, desmopressin, the synthetic analogue or naturally oc-curring antidiuretic hormone, could have a role in the management of female frequency, urgency and urgency incontinence. This work aims to review data on the use of desmopressin in females with storage symptoms. Available evidence indicates that desmopressin is eff-cacious in reducing nighttime urine production and epi-sodes of nocturia, resulting in fewer sleep interruptions. This translates into improved quality of life. Desmopres-sin is also effective in postponing micturition, urgency and incontinence for several hours after being taken on demand. The tolerability profle of desmopressin is good and signifcantly improved compared to historical figures due to the introduction of new oral formula-tions, tailoring the dose according to gender and age and adhering to instructions for fuid restriction before administration. The incidence of hyponatremia, desmo-pressin’s most important side-effect, is less than 3% in recent trials. The efficacy of desmopressin, combined with its improved safety profle, makes it an interesting method for treating female storage lower urinary tract symptoms.