27 nocturnal urinations per night. Who is the culprit?

Case Sharing: The patient is a 62-year-old female who is from Beijing and has settled in Qinghai to support the border. The patient’s overall appearance was emaciated and she was in poor spirits. After questioning her, we learned that she urinated at night as many as 27 times a night, and she had to put on a diaper before she went to sleep in order to feel at ease. During the daytime, she was no better, even if the toilet was right next to her, it was too late, and this incontinence had lasted for more than ten years. Her condition was so bad that she never dared to participate in social activities, and over time her quality of life was seriously affected, with poor sleep, no social activities, and both physical and psychological distress from the disease. During her illness, she had been to many hospitals and had undergone all the necessary tests, but still could not find the cause. The cervix, a unique part of the female body! The first thing that comes to mind for those who suffer from nocturia is a problem with the urinary system or the kidneys. However, if the patient is a woman, another cause of excessive nighttime urination can be easily overlooked, and that is – cervix-related diseases. This is easier to understand when combined with the structural diagram below. As seen in the diagram above, a simple elaboration is that the anterior wall of the uterus is adjacent to the bladder; the anterior part of the vaginal part of the cervix of the uterus is adjacent to the base of the bladder; and the posterior wall of the cervix of the uterus is adjacent to the rectum. Therefore, if there is inflammation of the uterus or inflammation of the cervix, it will constantly stimulate the bladder or the rectum, and one will be prone to urge to urinate and urinate frequently. This is what I often tell patients in the clinic, that if there is inflammation of the cervix, pre-cancerous lesions, or directly to the stage of cervical cancer, it will stimulate the front of the bladder, and cause a sense of frequent urination. After this patient’s cervical inflammation problem was solved with the progress of treatment, the problem of nocturia was greatly relieved, and eventually the nocturia could be reduced to 2-3 times/night, and she happily took my hand and said, “Thank you so much, Dr. Liu. I can’t describe how much I have suffered and how much I have been victimized in the past few years. I have low self-esteem for a long time, psychological depression can not breathe, always feel that I am a strange person, now I get up 1-2 times a night, occasionally 3 times, after sleeping well, the daytime spirit is also much better, now I can go out to walk, take a look at the mood to relax a lot of the body as a whole feeling has changed a lot, great! As a doctor the patient is happy because the problem is solved, the doctor is naturally more excited than her, and at the same time, I hope that this outpatient history can help more friends who have the problem of nocturnal enuresis but can’t find the cause.