Nocturia
Q1. I frequently wake up during the night to urinate. Do I have nocturia?
Nocturia, in Urology, refers to waking up more than once at night, i.e. two times or more, to urinate. First, we need to confirm if it is associated with urological issues, such as being awakened from deep sleep by the need to urinate.
Q2. Does nocturia only affect the elderly?
Nocturia does not only affect the elderly. It is more common among the elderly, but it also affects younger individuals.
Q3. How is nocturia associated with the risk of bone fractures?
Nocturia poses high risks to the elderly. Consider the scenario of someone waking up from a deep sleep by the need to urinate. Still feeling dizzy and unsteady, they must go to the toilet in the dark, making them more likely to trip and fall. The risk is even greater when the floor is slippery. As a result, they are at a higher risk of bone fractures from a fall.
Q4. Is nocturia caused by “Shen Kuai” (weak kidneys)?
In Western medicine, there is no such concept as “Shen Kuai” (weak kidneys). Kidney problems are considered as renal deterioration, but nocturia is not necessarily a symptom. There is no proven correlation between nocturia and “Shen Kuai” in Western medicine.
Q5. What causes nocturia?
Nocturia can be caused by different factors, but it is not always a urological problem.
In urology, nocturia is a major symptom of an enlarged prostate. It can be caused by prostate enlargement, which leads to incomplete emptying of the bladder. It also occurs when the bladder becomes less elastic. Some women may experience nocturia due to decreased ability to hold urine in the bladder, or sudden contractions of the bladder muscle. Other environmental factors may also contribute to nocturia, especially dietary habits. The preference for watery foods in Chinese cuisine can lead to increased water storage and bladder activity within a few hours after dinner. Those with prostate or bladder problems are more likely to wake up from deep sleep due to an urge to urinate during the night.
Nocturia can also be caused by another condition called polyuria, which may result from endocrine dysfunction. Normally, the kidney produces less urine at night due to a brain hormone. We can thus sleep through the night with most water being retained for excretion during the day. However, as we age, hormonal secretion may be impaired, leading to increased urine production at night. Consequently, even when the bladder and prostate are functioning properly, they may fail to handle the excess urine, resulting in nocturia.
Patients with other conditions such as diabetes, heart disease and hypertension are often prescribed with diuretics. It may affect nighttime urination. Those with edema due to poor circulation may need to elevate their legs at night, so that the water can return to the circulatory system. It also causes nocturia as the water is excreted through urine. In conclusion, nocturia is a complex issue with multiple causes.
Q6. What is the treatment for nocturia?
Treatment for nocturia is based on individual conditions, taking into account factors such as existing medical conditions. For example, patients with heart disease and hypertension are advised to take their diuretics earlier, i.e. 4 to 6 hours before sleep, so that they can pass urine before sleep and need not wake up for toilet during the night. Similarly, edema patients or seniors with poor leg circulation can try elevating their legs during the day, rather than only at night. These measures are quite effective.
You should consult a urologist if it has to do with urological issues such as an enlarged prostate or an overactive bladder. Treatment options like medications or surgery may be considered to manage nocturia and related urological symptoms. Medications are prescribed to relax the prostate, thereby facilitating urine flow and reducing nocturia. In case of an overactive bladder, medications can help relax the bladder muscles and increase bladder volume for urine retention. If you are diagnosed with polyuria, your doctor may prescribe a hormonal medication. Place it under your tongue once a night. It helps improve nocturia.
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