Urine Retention (nocturia): Why am I producing so much urine at night?

Posted by terwifwoods @terwifwoods, Oct 30, 2021

Hello,

Per my doctor, I am an otherwise healthy 40 something year old male who was been diagnosed with urine retention and voiding dysfunction (approximately six weeks ago). I've had a cystoscopy, which confirmed I have a very tight external urethral sphincter muscle and a hypertrophic bladder. I was doing self-catherization for over a month and pelvic floor stretches. I opted to have a foley catheter for the next month to relax the sphincter and bladder. I am awaiting a urodynamic study for further details, but its over two months out.

I am drinking 100 ounces of water or more each day per my urologist. I drink over half of the total in the mornings, and taper off through the afternoon. I stop drinking fluids at 6pm.

However, I noticed I am producing more than half of my daily output of urine between 11PM - 5AM, even though I empty myself before bed. When I was self cathing, I would void 300-400 ml on my own and cath another 400-700ml at night! When I wake up with my foley cath, I consistently have over 1000ml in my nigh bag. I asked my urologist and doctor why my urine output is so high at night and they do not know.

WHY am I producing so much urine at night?

Prior to the urine retention problem, I would get up once at night to pee 2-4 times a week, and my prostate is fine. I occasionally snore and my wife has not noticed any issues with breathing during sleep. I was tested for sleep apnea three years ago and it was negative. I exercise at least five days a week and was in the best shape of my life prior to the retention issues.

Could this be hormonal or neurological? Does the fact I worked a swing shift for fourteen years (off at midnight-ish) influence this?

How can I get my urine production to increase during the day and decrease at night?

Please help! I'd like some type of guidance so I can get my life back on track...

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@sbwitte

Hello @terwifwoods, I tried to reply to your other posting, but I'm not sure if I succeeded or not.

I have sleep apnea since 2014 and I'm also using catheters for the past month. I have not drawn a connection between apnea and urine output. I'll keep this question in mind and post updates. But I have a question for you: How on earth do you sleep while using self catheters? I find that I only get 1 or 1 1/2 hours of sleep, then I'm in agony until the next self cath. How do you do it?

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Hello @sbwitte. I self cath 3-4 times per day. At night, I get 3-6 hours of sleep before I wake up. Sometimes I have a strong urge to urinate and sometimes it’s weak. I take melatonin after self cathing in the middle of the night. Initially I could not fall back asleep. I now concentrate on deep breathing and progressive muscle relaxation to fall back asleep, which works more often than not. I usually awake around 6am and have to self cath a large amount again. I’ll self cath after lunch and before bed, which are usually smaller amounts. I started using the Calm app which has meditation on it that may help you relax and get back asleep. Hope this helps.

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@terwifwoods

Hello @sbwitte. I self cath 3-4 times per day. At night, I get 3-6 hours of sleep before I wake up. Sometimes I have a strong urge to urinate and sometimes it’s weak. I take melatonin after self cathing in the middle of the night. Initially I could not fall back asleep. I now concentrate on deep breathing and progressive muscle relaxation to fall back asleep, which works more often than not. I usually awake around 6am and have to self cath a large amount again. I’ll self cath after lunch and before bed, which are usually smaller amounts. I started using the Calm app which has meditation on it that may help you relax and get back asleep. Hope this helps.

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Thank you appreciated

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My husband's bladder was not fully emptying and he had a urolift procedure (urologist) to provide stents to the prostate so that the ureter would not be pinched. It was a simple, in office thing; but it sure relieved the retention. It works even though he does drink a lot of water at night. He is also diabetic-have they looked at that?

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Bill has seen the ads for a Urolift and has been thinking of asking his doctor about one. He is 88 with a lot of health issues - rare leaves his lift recliner other then bathroom 'runs'. He is on generic Flomax and Avodart but still goes a lot. And has an incontinent problem. Most of the time he doesn't even realize he has started. He doesn't drink liquid's after six o'clock other than taking his night pills. Seems to empty his bladder but has to go about every hour or so - makes sleeping really difficult (he uses a bottle as has fallen a few time getting up at night).

I wonder if he would be a good candidate for a Urolift?

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@mpeters

I read not too long ago that medication will be available for this.

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@mpeters, source?

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@ubikings

I don’t remember specifically and have read many books and articles since then. I read Medscape every week and other reliable sources of medical information.

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Might not be relevant, but my husband's prostate was crowding his ureter so he was not completely emptying. He had a urolift. Of course, he is in his 70s, and earlier treatment might have prevented bladder damage (it looks like the moon). It sounds like you are really attending to the problem and I hope a better answer shows up.

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@billchitwood

Bill has seen the ads for a Urolift and has been thinking of asking his doctor about one. He is 88 with a lot of health issues - rare leaves his lift recliner other then bathroom 'runs'. He is on generic Flomax and Avodart but still goes a lot. And has an incontinent problem. Most of the time he doesn't even realize he has started. He doesn't drink liquid's after six o'clock other than taking his night pills. Seems to empty his bladder but has to go about every hour or so - makes sleeping really difficult (he uses a bottle as has fallen a few time getting up at night).

I wonder if he would be a good candidate for a Urolift?

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I am 78 and also thinking about Urolift or similar procedure. I've been taking a generic Flomax (Tamsulosin) for many years for problems emptying my bladder. I too would get up 3+ times a night for bathroom trips even after starting on the Tamsulosin. Then by chance, I had switched pharmacies and when I refilled the RX, the pharmacist went over the medication and told me it should be taken in the evening. All along I had been taking it in the morning with my blood pressure meds. Now I usually only have to get up once at night for a bathroom trip.

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@johnbishop

I am 78 and also thinking about Urolift or similar procedure. I've been taking a generic Flomax (Tamsulosin) for many years for problems emptying my bladder. I too would get up 3+ times a night for bathroom trips even after starting on the Tamsulosin. Then by chance, I had switched pharmacies and when I refilled the RX, the pharmacist went over the medication and told me it should be taken in the evening. All along I had been taking it in the morning with my blood pressure meds. Now I usually only have to get up once at night for a bathroom trip.

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Turns out Bill has been doing the same thing! Taking as generic Avodart at night and the Tamsulosin in the morning. At one point the doctor had him taking the Tamsulosin 2x a day and he was peeing worse than ever. Will try switching to evening on him and see if that helps. Thank you.

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@johnbishop

I am 78 and also thinking about Urolift or similar procedure. I've been taking a generic Flomax (Tamsulosin) for many years for problems emptying my bladder. I too would get up 3+ times a night for bathroom trips even after starting on the Tamsulosin. Then by chance, I had switched pharmacies and when I refilled the RX, the pharmacist went over the medication and told me it should be taken in the evening. All along I had been taking it in the morning with my blood pressure meds. Now I usually only have to get up once at night for a bathroom trip.

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Wonder how many men are in similar situations never having been told to take it at night. My prescription is twice a day and have had the same issue.

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