Nocturia

Many people experience having to get up in the middle of the night to go to the toilet. Dr Joe Kosterich talks about nocturia, including causes, simple measures to treat it, and when to talk to your doctor about it.

Many people have had the experience of having to get up in the middle of the night and go to the toilet if they’ve had maybe a drink or two too many the previous evening.

Hi, I’m Dr Joe and in this video we’re going to be talking about nocturia, which is the fancy medical Latin term for passing urine in the middle of the night.

There are a number of reasons why this may occur and they start from the very simple and insignificant through to perhaps more significant medical reasons. Some people have “stronger” or “weaker” bladders, for some people they’ve sort of always had a tendency to go once at night-time and there’s nothing particularly right or wrong about that, it is a tendency. If for some people, they don’t like the fact that they have to get up in the middle of the night, sometimes the simplest trick is to have little bit less liquid maybe after 6 or 7 o’clock at night. But if it’s been a fairly steady thing and it’s not changing then this is very rarely going to be a problem.

There are different reasons why males and females may get nocturia. For males the most common reason, as they get older, is enlargement of the prostate. Not all enlargement of the prostate is cancer of the prostate. All men if they live long enough will get some enlargement of the prostate, and as that does happen it squeezes the urethra, which is the tube where the urine flows through, and it may cause men to have to go more frequently to the toilet during the day and also during the night. The most common reason as we said is enlargement of the prostate and that’s benign rather than cancerous but, obviously, if this is happening to you then you need to get checked perhaps for cancer of the prostate as well.

In females the most common reason is because of issues with the pelvic floor, and in turn the most common reason for that may be after pregnancy or childbirth. Once upon a time – and it’s not that long ago – there was this sort of view this was passed down from the generations, sort of “oh well, dear, you just have to put up with it.” It’s really important to be aware that it’s not something you have to put up with. Today there’s a much greater understanding of what causes these problems in the pelvic floor and treatment can start from day 1, so there’s a big emphasis on pelvic floor exercises after childbirth. Now, some women sort of roll their eyes and think, “I don’t really want to do that.” But believe me, you will appreciate it down the track if you do your pelvic floor exercises.

We can go a little bit more fancy than that and some women will benefit from some ultrasound type treatments, and there are a number of physios these days that specialise in this area, and also continence advisors who can also help with problems with the bladder. For some women, if it’s not responding to simple measures, surgery can be done as well.

There are other reasons why people may be getting up at night to pass urine and it can sometimes reflect problems with the kidneys. It may also relate to what is going on with the heart and circulation. Some medications can cause you to need to pass urine either as a side effect or if you’re on, for example, fluid tablets, particularly for high blood pressure, you may find that you’re going more often to the toilet. In all of these sorts of instances it’s very important to have a chat with your doctor. If you’ve been started on some new medication and it is causing side effects then there may be possibilities to change it. If there have been changes in your patterns of passing urine, it doesn’t always mean there is a medical issue but it would be important to chat about it with your doctor.

As we’ve outlined above, in most instances there is going to be some sort of treatment available. It may be very simple, it might be as simple as adjusting your fluid intake through the day, it may require surgery and there’s all the points in between.

So, to sum up, passing urine at night: of itself may not be particularly significant. If there are changes then you certainly need to be talking to your doctor. If it’s troublesome or bothersome then there often are treatments available and they may not be as complicated as you might think.

More information on Nocturia.