Managing Nocturia and Frequent Urination: Insights and Solutions

Q: Managing Nocturia and Frequent Urination: Insights and Solutions

Hello, sir： 1. <br>Behavioral control training can be performed independently or in conjunction with medication; the two approaches do not contradict each other. <br>2. <br>The body can sense changes in surrounding temperature; when the temperature is too high, it cools down thro

Nocturia and urinary frequency issues?

Hello, I have been frequently waking up at night to urinate (usually once) since the beginning of this year.
Recently, after a doctor's examination, I was diagnosed with overactive bladder.
I have been taking Terodine F.G.
and Tamsulosin for 2-3 months.
I have noticed significant improvement in daytime frequency, but the effect on nighttime urination has been moderate (I still experience nocturia at times).
However, in the past 1-2 weeks, I have started to feel some postural hypotension (dizziness when standing up too quickly after squatting) and have experienced some difficulty urinating (slow urination).
After researching online, I decided to stop the medication for the past 3-4 days to observe the results: the "difficulty urinating" situation has improved.
However, despite the high temperatures in Taipei not rising significantly (from a record-breaking 38.5°C back to 35-37°C), I feel like my body seems to be sweating more— I have a tendency to sweat excessively (in addition to my body, my feet also tend to sweat easily in the summer).
I would like to ask the following two questions:
1.
Given the side effects of the medication and that my current condition diagnosed by the doctor does not seem very severe, along with some methods available online and on television for improving habits and bladder training, would it be feasible to change some habits and undergo training on my own without medication? Or would it be better to seek assistance from a hospital or specialist for training?
2.
I have noticed that my sweating has increased in the 2-3 days since stopping the medication.
Could this be related to my body transitioning from slightly low blood pressure to normal blood pressure after discontinuing the medication? Previously, after taking the medication for a month, my blood pressure readings were consistently between 90-100, which is lower than my average of about 115 from previous health check-ups over the years.

Jun, 50~59 year old female. Ask Date: 2016/07/31

Dr. Chen Jiansheng reply Urology

Hello, sir: 1.
Behavioral control training can be performed independently or in conjunction with medication; the two approaches do not contradict each other.
2.
The body can sense changes in surrounding temperature; when the temperature is too high, it cools down through sweating.
A small percentage of individuals may have a stronger reaction to tamsulosin, which can indeed lead to hypotension.
Chen Jian-Sheng, Department of Urology, New Taipei City Hospital.

Reply Date: 2016/07/31

More Info

Managing nocturia and frequent urination can be a complex issue, especially when it involves medications like Terodine (terazosin) and Tamsulosin, which are commonly prescribed for overactive bladder and urinary symptoms. Your experience of nocturia, the need to urinate at night, and the recent development of urinary hesitancy or difficulty in urination are significant concerns that warrant careful consideration.

1. Medication and Side Effects
The medications you are taking can indeed have side effects that impact urinary function. Terazosin and Tamsulosin are alpha-blockers that work by relaxing the muscles in the bladder and prostate, which can help alleviate urinary symptoms. However, they can also lead to side effects such as dizziness, low blood pressure, and urinary hesitancy. The fact that you noticed an improvement in your urinary flow after stopping the medication suggests that the medications may have been contributing to your symptoms.

It's essential to communicate with your healthcare provider about these side effects. They may consider adjusting your dosage or switching you to a different medication that may have a more favorable side effect profile for you.

2. Non-Pharmacological Approaches
Regarding your question about managing your symptoms through lifestyle changes and bladder training, this is indeed a viable option. Many patients find success with behavioral modifications, which can include:
- Bladder Training: Gradually increasing the time between urinations can help train your bladder to hold more urine.

- Fluid Management: Monitoring your fluid intake, especially in the evening, can help reduce nighttime urination.

- Pelvic Floor Exercises: Strengthening the pelvic floor muscles can improve bladder control.

- Dietary Changes: Avoiding irritants such as caffeine, alcohol, and spicy foods may help reduce urinary frequency.

Consulting a specialist, such as a urologist or a pelvic floor physical therapist, can provide you with tailored strategies and support for bladder training and lifestyle modifications.

3. Increased Sweating and Blood Pressure Changes
Your observation of increased sweating after stopping the medication could indeed be related to changes in your blood pressure. Medications like Terazosin can lower blood pressure, and when you discontinue them, your body may adjust back to a more normal state, which can lead to increased sweating, especially if you have a predisposition to hyperhidrosis (excessive sweating).
It’s also worth noting that the body’s thermoregulation can be affected by various factors, including hydration status, ambient temperature, and physical activity levels. If you are experiencing significant changes in sweating or other symptoms, it’s advisable to discuss these with your healthcare provider to rule out any underlying issues.

Conclusion
In summary, managing nocturia and urinary frequency involves a multifaceted approach that includes medication management, lifestyle modifications, and possibly behavioral therapies. It’s crucial to maintain open communication with your healthcare provider about your symptoms and any side effects you experience. They can help you navigate the best course of action, whether that involves adjusting your medication, implementing non-pharmacological strategies, or further investigating your symptoms.
If you continue to experience difficulties, consider seeking a referral to a specialist who can provide more focused care. Your health and comfort are paramount, and there are many resources available to help you manage these symptoms effectively.

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