The bedside clock glows in the dark, a luminescent progression of green. You rise to empty your bladder. The numbers advance. You relieve yourself again. And again. Then some more.
Frequent urination in men, especially at night, can signal a serious underlying disorder. It can even predict one.
“They are tired, are not having restful sleep, are urinating multiple times a night,” said Hector Pimentel, MD, a urologist with Spectrum Health Medical Group. “You can detect a lot … with an ultrasound in the office. It takes 30 seconds.”
It could be time well spent, as those endless trips to the loo could be hinting at something else: Sleep apnea? Diabetes? Prostate problems? An infection? A neural disorder?
For many of his male patients, the answer may be yes to any one of those, said Dr. Pimentel, one of the Spectrum Health urologists who specialize in stone disease and inflammatory disorders of the urinary tract.
As men age, they’re more likely to develop serious issues with their urinary tract.
Urinary problems typically begin at about age 50, Dr. Pimentel said, and by age 80 about half of all men have underlying or predictive conditions.
Health professionals are only likely to see more of this sort of ailment as the Baby Boomer generation continues aging. In Michigan’s Kent County alone, there are about 300,000 men age 65 and older, a 5 percent increase since 2005.
Fortunately, it’s not doom and gloom when you talk about frequent urination and the ailments it may herald. Urinary problems and the possible underlying conditions can be managed, although it’s best to be proactive, not reactive.
“Most patients will have something serious that can be managed, often by changing habits and diet, and sometimes medication,” Dr. Pimentel said.
Frequent urination could be hinting at any of these ailments:
Symptoms of sleep apnea include habitual snoring, feeling unrefreshed upon awakening, and daytime sleepiness or fatigue.
Sleep apnea causes soft structures in the airway to close off, which decreases oxygen and increases carbon dioxide. The heart rate then drops and the lung vessels constrict, and the sleeper must wake up enough to reopen the airway. As the heart begins to race, it experiences false fluid overload and tells the body to get rid of sodium and water—thereby causing frequent urination.
Apnea-related high blood pressure, obesity and respiratory problems impact mood, quality of life, functionality and vigilance. Losing weight and quitting smoking is key. CPAP devices (continuous positive airway pressure) can also bring significant improvement.
This is perhaps the most common underlying condition associated with frequent urination, Dr. Pimentel said.
Kidneys must work harder to filter and absorb excess blood sugar, which is excreted into the urine with fluids from tissues. This triggers ever more frequent urination. And as you drink more to quench your thirst, you’ll urinate even more.
Exercise can help you avoid the serious health complications of diabetes. It helps you lose weight, it lowers your blood sugar, and it boosts your sensitivity to insulin, which helps keep blood sugar within a normal range.
Every pound you lose can improve your health. Fiber—fruits, vegetables, whole grains and such—improves blood-sugar control and lowers your risk of heart disease.
Enlarged prostate usually affects men age 50 and older. The enlarged gland can block urine flow, resulting in infections, bladder stones, incontinence or an inability to urinate.
As the prostate enlarges, it can cause urine to remain in the bladder and it can put pressure on the urethra. This makes the bladder contract even more to expel urine. Over time, the bladder muscle may then become overly sensitive, contracting even when it contains only a small amount of urine.
A range of treatments can relieve enlarged prostate symptoms, including medication, minimally invasive procedures and surgery.
These hard masses develop in the bladder when urine becomes concentrated, causing minerals to crystallize. Small kidney stones can also travel to the bladder and grow into bladder stones.
To avoid developing bladder stones, drink plenty of liquid. Many juices containing citrates can reduce the risk of developing stones, although orange juice is most effective, according to a study in the Clinical Journal of the American Society of Nephrology.
It’s important to recognize and treat any underlying problems that may be causing bladder stones, including infection, blockages and such. (Even a poor diet can play a role in causing bladder stones.)
There are various ways to diagnose bladder stones, including a physical exam, urinalysis, CT scan, X-ray and ultrasound. Endoscopy—a procedure involving a small tube outfitted with a small camera—can be used to view the area closely, allowing doctors to use various procedures to fragment the stones for easier passage from the body. In some cases, surgery may be needed to remove the stones.
All neurodegenerative diseases affect the brain and nervous system. As such, they can cause bladder problems such as frequent urination. This would include diseases such as Parkinson’s, multiple sclerosis and Alzheimer’s.
Among people with Parkinson’s, for example, many of them commonly experience the need to urinate frequently, and they also have trouble delaying urination. (These diseases trick the brain into thinking the bladder needs to be emptied, when in fact it does not.)
While there’s no cure for these diseases, new treatments are being developed and new discoveries are being made.