If I have to pee all night, is it just a prostate problem?
Jul 15, 2024
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Night urination refers to waking up more than once during sleep time, and clinically, it is often said more than twice.
At this time, it means sleep time even if it is not at night, so night workers also include those who go to pee while sleeping during the day. Studies have shown that if night urination is not treated, fatigue or depression due to sleep disorders increases, and the risk of falls or hip fractures increases, especially in the elderly.
▶ It's not just a problem with the prostate…You need to consider medication, diabetes, etc
Night urination has been reported to be about 33% of those in their 40s or older in Korea, and about 48% of those who wake up once at night and more than twice, and the prevalence of night urination has been reported up to 25-50% in the United States and Europe. As is commonly recognized, the prevalence rate increases with age, and it is reported in about 20% of those in their 30s and nearly 40% of those in their 60s and older.
Many people, especially in men, consider the cause of night urination to be prostate hyperplasia, but night urination has various causes, and prostate hyperplasia is only one of the many causes of night urination.
Examples include bladder storage problems, night polyuria, or polyuria, and sleep disorders. Nighttime polyuria is the most important cause, and usually at night, anti-diuretic hormone is secreted, reducing urine production, and decreasing anti-diuretic hormone secretion increases urine production.
Professor Park Jae-won of the Department of Urology at the National Health Insurance Ilsan Hospital said in this regard "The primary abnormality of the pituitary gland or the process of reabsorption of moisture in the lower body during the day." However, water intake at night may also be directly related, and other factors that may cause nightly polyuria, such as drugs such as diuretics, congestive heart failure, diabetes, and obstructive apnea, should also be considered," he stressed.
In addition, hypersensitivity bladder, which can cause bladder storage problems, neurogenic bladder, as well as bladder outlet obstruction, including prostate hyperplasia, which decreases substantial bladder volume due to increased residual urine, can also be the cause.
In addition, since the meaning of waking up in sleep is subjective, it is necessary to distinguish well whether you wake up because you want to pee or go to pee while you wake up, and in the latter case, the possibility of sleep disorders should be considered.
▶ Lifestyle changes and drug treatment are prioritized over surgery
Treatment is the first change in lifestyle. It is recommended to exercise during the day and it is also good to improve your sleep environment, restrict water intake after urination before bed and after evening or 2 hours before bed. It's also good to refrain from drinking or eating fruit. If you take diuretics at night, control the time you take them. In the case of the elderly, compression stockings should be used to prevent moisture from gathering in the lower extremities, or underlying diseases such as diabetes and kidney failure should be managed together.
Second, drugs can be used to increase bladder volume. In hypersensitivity bladder, anti-muscarinics can be used to control nightly frequent urination, or alpha blockers can be used to control frequent urination in men with prostatic hypertrophy or if there is a lot of residual urination due to neurogenic bladder.
The third is a treatment that prevents urine production at night. Even if other factors such as evening water intake are improved, if polyuria persists at night, anti-diuretic hormone can be taken to reduce urine production. Desmopressin, a synthetic organism of antidiuretic hormones, concentrates urine in the kidneys and reduces urine production, delaying urination. However, since there is a risk of hyponatremia, it is necessary to check the blood sodium concentration before and at the beginning of use.
In the case of surgery, it can be expected to reduce night urination by improving urinary tract obstruction and improving bladder hypersensitivity, but because night urination has various causes, we cannot be sure of improving symptoms through surgery, and we should avoid thinking of surgery first to improve night urination.
Professor Park Jae-won said, `In conclusion, night urination is frequently frequent and reduces the quality of life, but many people often regard it as part of aging or as a treatment target. However, since there are various causes and treatment can be done through lifestyle correction or medication, it is important to choose the right diagnosis and treatment method accordingly.
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