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Dr. Tharun
Dr. Tharun, Urology Resident
Category: Urology
Satisfied Customers: 3682
Experience:  MBBS, DNB surgery and presently working as Urology resident towards the degree of Urologist.
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Hi I am married,male,69yrs,21stone,non smoker, alcohol 4/5

Resolved Question:

Hi I am married,male,69yrs,21stone,non smoker, alcohol 4/5 pints lager per week, go to gym 4/5 times per week, fairly active.
Generally I feel very well.active and with it,except for this urology problem that is just tires me out every night

I have prescription for amlodipine,dozazosin,dutasteride,furosemide,ramipril,simvastatin,tamsulosin,latanoprost eye drops, warfarin.

On an average day I drink a total of 2litres mainly tea and milk, and I discharge approx. the same.Although I feel that I am retaining liquids.
I also have an enlarged breast that was caused by the prescribed medication Bindro? water tablet
Very little urine during the day during the day, but 4/6 times during the night every night from 10.30 pm 200mls/400mlseach time up to 8.00am.
I do not take liquids after 8.30pm
I currently take the furosemide 20mg at 3 00 pm each day.which I was told to stop as they did not reduce the night time uninary frequency.
I attend prostrate clinics for the past 3 years. Pretty much a waste of time.
The urology consultant has written to me stating that "recent blood and urine tests have shown no abnormalities, and unfortunately we haven't been able to find any good treatment for your night time urinary frequency." and haS DISCHARGED ME BACK TO MY GP.
Have you any advice, could it be hormonal? regards XXXXX XXXXX
Submitted: 3 years ago.
Category: Urology
Expert:  Dr. Tharun replied 3 years ago.
Are you taking Doxazosin and tamsulosin both?

Have you tried vesicare or detrusitol or other bladder relaxants ?

Do you have any heart problems ?

Have you checked for diabetes insipidus?

Please let me know.

Dr.Tharun
Customer: replied 3 years ago.

Hi yes.


I take Doxazosin 4mg one per day.morning.


I take Tamsulosin 400 microgram with evening meal.


 


No bladder relaxants.


 


No heart problems other than high blood pressure.


 


Yes been checked for diabetes


 


regards mike

Expert:  Dr. Tharun replied 3 years ago.
HI Mike,

Night time urinations could be due to two reasons - overproduction of urine at night as it happens in cardiac failure or generalised body swelling. As we sleep in a horizontal position, these water swelling return to the heart which pumps more blood and hence more urine production.So all patients with night time urination should be tested for these problems.

Second reason is small capacity bladder- so the urine fills up fast and you have to empty it more frequently. But this should happen at day time too.Since you have this problem only at night, we have to look for other reasons.

Block in the urine flow is also a reason for night time urination. But since you are already in a prostate clinic this would have been diagnosed by now.

So you should get tested for heart problems and other conditions which causes body swelling.
In the meantime you can try bladder relaxants - like oxybutynin, vesicare, detrusitol or trospium. These drugs relaxes the baldder and hence decreases night time urination.
Desmopressin is another drug which can decrease urine production drastically. This can be taken as a nasal puff or oral tablet as required.Only problem is that it can reduce the salt content of our body.

Botox injection is a novel therapy which has been recently introduced for this problem. Botox partially paralizes the bladder and so reduces the number the times you have to void.
Doxazosin and tamsulosin are similar drugs and there is very little gain acheived by taking them together.

So you can discuss these options with your doctor and try some options. If you have any doubts or questions, please let me know.

Dr.Tharun
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