>>> dr. jerry blaivas: getting up in the middleof the night to urinate is called nocturia. nocturia is very very common, in fact mostpeople get up once or twice at night to urinate starting in the teenage years even. if you think about it, there is only two possiblereasons why someone would get up in the middle of the night to urinate. one is that theirbladder does not comfortably hold enough to allow them to sleep through the night, and,two, you make more urine, that it is to say your kidney is making more urine then yourbladder cannot comfortably hold overnight. the second condition, we called nocturnalpolyuria. the nocturnal means nighttime and poly means too much and uria means urine.so nocturnal polyuria means that you make
too much urine overnight and that is probablythe commonest cause of nocturia. the most common cause of that even is justdrinking too much before you go to sleep. so if you have a couple of beers or you havewine before dinner and then you take a glass of water with some pills, all of that fluidthat you ingest will then overnight be converted by the kidneys to urine and then if you makemore urine overnight than your bladder can hold, then of course you have to get up tourinate. so nocturnal polyuria is the commonest causeand the other cause, the bladder not holding enough urine, has many many many causes. probablythe most common one is, temporary problem is, urinary tract infection. it can be causedby blockages by the prostate. it can be caused
by bladder cancer, by all kinds of other irritablekind of conditions so thinking back then we have these two different causes, making toomuch urine at night or the bladder not holding enough at night. so, then what to do aboutit. well the first thing you need to do aboutit is to diagnose it. how do we diagnose it? very - very simply! we have you keep a bladderdiary, that is to say you record the time and amount of urine, time and amount of eachurination that you make in a 24-hour period, then we simply see how much you urinate atnight, how much you urinate for the 24-hours and through some mathematical formula, wecan figure out if you are making too much urine at night.
generally, people make less than a third oftheir urine during sleep hours. if you make more than that then you have this nocturnalpolyuria and we look for the causes of that. i briefly alluded to what they were in thebeginning but now to get more complete, the most common cause is simply drinking too much. probably the second most common cause is peoplethat take medications at night that can have a diuretic like effect. another cause is anythingthat causes your legs to swell up, so people with varicose veins or from prior surgery,if your leg swell up during the day that the swelling is actually fluid and when you liedown at night, your body resorbs that fluid, that fluid gets into your system and the kidneysmake more urine.
another common cause is something called sleepapnea, people who snore, best diagnosed by going to a sleep lab and if you have sleepapnea, then that is what causes the problem and the treatment of the sleep apnea is theproblem. the bladders that do not hold enough urine,again we first determine that by the bladder diary and then we look for the common causes,common causes of urinary tract infection, prostatic obstruction, dropped bladder inwomen, overactive bladder, sometimes bladder cancer, bladder stones, no matter what theycause though, once the diagnosis is clearly understood then treatment of the underlyingcondition that is causing the nocturia is very often effective, it is usually effective.
however, just having nocturia, just gettingup at night to urinate by itself does not demand any treatment. so if you get up once or twice at night orthree times and you are not bothered by it, there is no need for any treatment at all.if there is a need for treatment, if you are bothered by it, rest assured there just aboutalways an effective treatment.
