Night time urination frequency post radiation

When first diagnosed in 2018 (Gleason 8-9), I had immediate Casodex and brachytherapy, followed by the first of only two (total) Lupron injections. I then had seven weeks of daily IMRT sessions, with a second and final Lupron injection upon completion. My Total-T at time of departure was 20 ng/mL and it stayed below 100 ng/mL for more than 2-years before slowly starting to climb. At years #4 and 5, it had climbed to an early-morning maximum of 220-230.

At years #6, I agreed to supplemental bi-monthly testosterone injections, which I maintained for about 4-months total, without ever feeling much (if any) benefit from it. Knowing the risks associated with it, I then decided to quit the injections. By year #7, it had risen to ~425 ng/mL, and at year #8, I was diagnosed with recurrence.

@surftohealth88

I looked at AZO, the packaging says to use for only 2 days, 2 pills 3x a day after meals (short term use for UTI antibiotics to kick in). Has your husband's RO told you differently?

My RP surgery was in 11/2024. PSA in 7/2025 was 0.02. PSA in 10/2025 was 0.04. I asked the urologist if recurrence and radiation were likely and he said yes, then encouraged me to see the radiation oncologist. Rad Onc said I was still well below the threshold but because I was trending in the wrong direction and my earlier results (G9, bladder neck invasion, multi-focal, cribriform and so on) he recommended moving ahead with radiation. I had the Lupron 10/15/25 and started the radiation a little more than 6 weeks later - 39 sessions ending 2/4/26. PSA has been undetectable since. My hot flashes are happening less often, mostly at night.

@carlsbadguy
I do not know what kind of AZO you have, we bought AZO bladder control and it can be taken indefinitely.
Actually the full effect is seen after 30 days of use. It contains only pumpkin seeds and soy.
Hope this answers you question.

@climateguy
We bough "bladder control" , the one that is only containing pumpkin seed and soy. What you used is actually kind of medication that numbs bladder lining. It is as any other medication a "quick fix" that masks symptoms. AZO with pumpkin and soy works by promoting healing.

Here is what AI says about pumpkin:

Pumpkin Seed Extract: Contains healthy fatty acids, magnesium, and zinc that help relax the bladder's detrusor muscle and reduce spasms causing sudden urges. Phytosterols in the seeds also support prostate health in men and reduce lower urinary tract inflammation

Soy:
Soy Germ Extract: Provides plant-based isoflavones (phytoestrogens) that may improve pelvic floor muscle tone and bladder control.

Combined Effect: Clinical studies, such as trials on the supplement blend known as Cucuflavone, show that taking these extracts together for 12 weeks can significantly lower daytime frequency, nighttime waking, and urgency episodes.

Hope this helps with explaining how "AZO bladder control" product works so well for my husband.

I underwent 42 Proton therapy sessions with concurrent ADT. Started with Firmagon, but after two weeks, switched to Orgovyx when that was finally authorized, and continued that for additional 60 days. Frequency of urination increased over the period of treatment and after. That has been mostly during the day. (FYI - I take 40mg of hydrochlorothiazide in the morning due to high blood pressure). Normally, I have to get up once overnight, though 2-3 times a week, I do not have to get up at all. I have been exceedingly lucky. Over a period of six months. I have probably only had to get up as many as three times on 4–5 occasions, and never more than three times. My problem has been weak stream, so weak that it has become problematic to attempt to use a urinal.

@surftohealth88

Thanks for the clarification, I haven't purchased any AZO, just perusing Amazon and the product with phenazopyridine is the most recommended and one that states to only use for a 2 day period. In the past I have taken True Nature Prostate Complex, which contains saw palmetto, zinc, lycopene and pumpkin seed, It worked well, but nutritionist said to discontinue during radiation due to zinc and lycopene. I eat salted pepitas, or pumpkin seeds almost every day. I'll look for the AZO bladder control product.

Took my bladder almost a year to settle down after 40 sessions of pelvic imrt. Also on orgovyx and zytiga. Right after treatment I was getting up 4 or 5 times a night and often had extreme urgency events during the day. Things slowly improved over time and presently no issues during the day but still can't get through the night without a couple trips to the bathroom. Perhaps not that unusual for a 70 year old. Was using flowmax early on but stopped due to it didn't seem to be improving things. My bet is your situation will improve with time. I believe taking long walks daily helped me also.

Thanks for the comment. This is encouraging!

Oh yeah, I forgot to mention that cutting back on sodium intake may be helpful