Nocturia: Causes and Effects of Nighttime Urination

Q: Nocturia: Causes and Effects of Nighttime Urination

Hello： 1) At your age, you may have benign prostatic hyperplasia (BPH). <br>Hanalidge Ocas is a medication used to treat this condition. <br>Clinically, some patients experience fluctuating urinary symptoms, but it can be discontinued after three years, which is uncommon; this ma

Nocturia

Hello, doctor.

1.
Currently, I am experiencing the need to urinate about 3 to 4 times at night, which is somewhat bothersome.
Five years ago, I had a similar issue and was treated with "Harnalidge OCAS 0.4 mg (tamsulosin)" which improved my condition.
Three years ago, after undergoing surgery for a foot fracture and being hospitalized for 5 days, I had my catheter removed and surprisingly was able to sleep through the night, urinating only occasionally.
Therefore, I discontinued the use of "Harnalidge OCAS 0.4 mg." However, six months ago, the nighttime urination returned, but this time it is somewhat different as I always experience penile erections.
Doctor, does nighttime penile erection affect the urge to urinate?
2.
Doctor, is there a medical term for "hypersexuality"? Thank you.

LKKO, 60~69 year old female. Ask Date: 2020/07/28

Dr. Du Shixi reply Urology

Hello: 1) At your age, you may have benign prostatic hyperplasia (BPH).
Hanalidge Ocas is a medication used to treat this condition.
Clinically, some patients experience fluctuating urinary symptoms, but it can be discontinued after three years, which is uncommon; this may indicate that your prostate is not significantly enlarged.
However, I recommend that you go to a hospital for evaluation.
As for whether nocturnal penile erections affect the urge to urinate, there is a relationship between the two.
2) Hypersexuality is present, but a definitive diagnosis is necessary, which may require evaluation at a major hospital.
A diagnosis should not be made lightly.
Wishing you good health.

Reply Date: 2020/07/28

More Info

Nocturia, or nighttime urination, is a common condition that can significantly affect a person's quality of life. It is characterized by the need to wake up during the night to urinate, which can disrupt sleep and lead to daytime fatigue. Understanding the causes and effects of nocturia is essential for effective management and treatment.

Causes of Nocturia
1. Fluid Intake: One of the most straightforward causes of nocturia is excessive fluid intake before bedtime. Drinking large amounts of fluids, especially those containing caffeine or alcohol, can lead to increased urine production at night.

2. Medical Conditions: Various medical conditions can contribute to nocturia. These include:
- Diabetes: Both diabetes mellitus and diabetes insipidus can cause increased urination, including at night.

- Heart Failure: Fluid retention during the day can lead to increased urination at night when lying down.

- Prostate Issues: In men, conditions such as benign prostatic hyperplasia (BPH) can obstruct urine flow and lead to nocturia.

- Urinary Tract Infections (UTIs): Infections can irritate the bladder, causing an increased urge to urinate.

- Sleep Apnea: This condition can lead to nocturia due to the body's response to low oxygen levels during sleep.

3. Medications: Certain medications, particularly diuretics (often prescribed for high blood pressure), can increase urine production.
4. Hormonal Changes: Antidiuretic hormone (ADH) helps regulate urine production. Changes in hormone levels, especially in older adults, can lead to decreased nighttime urine concentration.

5. Age: As people age, the bladder's capacity may decrease, and the ability to concentrate urine may diminish, leading to more frequent nighttime urination.

Effects of Nocturia
The effects of nocturia can be profound. Frequent awakenings to urinate can disrupt sleep cycles, leading to:
- Daytime Fatigue: Poor sleep quality can result in tiredness, irritability, and decreased cognitive function during the day.

- Increased Risk of Falls: For older adults, getting up multiple times at night increases the risk of falls and related injuries.

- Emotional Distress: The embarrassment or frustration associated with nocturia can lead to anxiety and depression.

Addressing Nocturia
In your case, the recurrence of nocturia after a period of improvement may be influenced by several factors. The fact that you experienced a significant change in your nocturia pattern after your surgery and the removal of the catheter suggests that your urinary function may have been temporarily altered.
Regarding your specific questions:
1. Does nighttime penile erection affect urination? Yes, nocturnal penile tumescence (NPT) is a normal physiological response during sleep. It can sometimes coincide with the urge to urinate, but it does not directly cause increased urination. However, the sensation of an erection may heighten awareness of bladder fullness, leading to a perceived need to urinate.

2. Is there a medical term for increased sexual desire? Yes, the medical term for increased sexual desire is "hypersexuality." This condition can manifest in various ways, including increased sexual thoughts, urges, or behaviors. It is essential to differentiate between normal variations in libido and pathological hypersexuality, which may require intervention.

Conclusion
If nocturia continues to be a concern, it is advisable to consult a healthcare professional for a comprehensive evaluation. Keeping a bladder diary, noting fluid intake, and documenting urination patterns can provide valuable information for diagnosis and treatment. Treatment options may include lifestyle modifications, medication adjustments, or further investigation into underlying medical conditions. Addressing nocturia not only improves sleep quality but also enhances overall well-being.

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