What causes nighttime urination?
THURSDAY, MARCH 10, 2005

Dear Dr. Sangani: I have had several episodes over the past 2 or 3 years involving frequent urination at night, sometimes involving low flow and occasional light feverlike symptoms such as body shivers but without fever. I have been regularly tested and examined with no enlarged prostate and no urinary infections. I regularly take a prostate multivitamin. I have been told it may be a form of prostatitis and have taken antibiotics which now do not seem to help. I will also take Advil or Motrin quite frequently during episodes. Any suggestions would be appreciated. – Tired of Waking Up Dear Tired: After researching the subject of urinating at night with one of my urologist friends, it is quite clear that there are multiple causes of this condition, and you should be evaluated by your physician, especially if you are younger than 60, and that applies to both men and women.

Q: What causes someone to go to the toilet to urinate several times during the night? A: The term to describe frequent urination at night is nocturia. The problem is common in older men, because it can be caused by enlarged prostate. This is uncommon under the age of 60 but after that age it becomes more usual. Q: Are there other causes of nocturia? A: Frequent urination at night can be caused by excessive fluid intake before retiring, reduced bladder capacity, an enlarged prostate, infection, fluid redistribution, or failure of the bladder to concentrate urine at night. People who have been diagnosed with congestive heart failure, diabetes, or urinary tract infection commonly have nocturia. Medications such as diuretics can cause nocturia. Diuretics are given to people with high blood pressure, swelling or edema, or patients with congestive heart failure. Are you tired in getting a

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First let’s discuss excessive fluid intake, which includes alcohol drinks, caffeine containing drinks, or soda pops before you go to bed. These types of fluids stimulate urine production. Next a reduced bladder capacity can occur as you get older. An enlarged prostates pleases on the tube called the urethra and prevents the bladder from emptying completely. Infections of the kidney or bladder, and prostatitis can cause frequent urination, during the day and night. Fluid redistribution occurs when you lie down and the fluid in the ankles, legs thighs and fingers is reabsorbed in the blood stream and the kidneys produce more fluid which results in increased urination at night. People with congestive heart failure complain of nocturia. Normally, an adult produces two-thirds of total urine during the day and one third during the night. The kidneys produce a hormone to produce less volume at night and that is why the urine is concentrated in the mornings. As you grow older, the kidneys are less likely to concentrate urine and can result in increased urine production at night, which leads to frequent urination. Q: When should I see my doctor to evaluate this problem? A: If the episodes of awaiting at night to urinate occur more than several days, an evaluation by your physician is a must.

Q: How is nocturia evaluated? A: Your physician will ask questions and perform a physical examination. The types of questions asked include when did it start? How many times does this occur each night? Has there been a change in the volume of urine produced? How much urine is voided each time? Is there pain or burning when passing your urine? Have you had fever? How much fluid do you drink before you go to bed? Is there a family history of diabetes? Does nighttime urination interfere with sleep and rest? Have you changed your diet recently? For men a prostate exam is important to determine prostate enlargement. Q: What diagnostic tests, if any, are needed? A: Commonly ordered are blood tests to evaluate electrolytes, osmolality to determine concentration, and urinalysis to evaluate infection, and for sugar in urine. Q: How is nocturia treated? A: First your physician will evaluate the cause and treat accordingly. Steps you can take to decrease the number of times urinating at night include drinking liquid earlier in the day, no alcohol or caffeine containing liquids before bedtime, and managing your diabetes.

Do you have a question for the doctor? Submit them by email to Dr. Bharat Sangani at sangani@pol.net or by regular mail at 5601 Sound Bluff Road, Ocean Springs, MS, 39564. Link to original article: http://www.encore.bz/upNews/What%20causes%20nighttime%20urination.pdf

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