Nocturnal polyurea

I spoke to a doctor at my local GP practice about six months ago about the fact that I was getting up several times during the night to pass large quantities of urine. Last night is a good example: Bed at 11:00. Bladder empty. 12:45 - Passed at least a litre of urine 02:45 - Ditto Woke at 07:50 My doctor arranged for a blood test for possible prostate cancer, based on the fact that I had a test in January 2004, which proved to be negative. I now wake up very tired, and often feel like going to sleep late morning. I something sleep for over two hours in the afternoon, with no negative impact on my sleeping at night. The feeling of exhaustion is now semi-permanent, and much worse after a bout of activity, such as mowing the lawn.

Accepted Answer

Date:Jan / 2012

Thank you for your question.

Hi, sorry you are having trouble with this. There are several causes of urinary frequency and/or nocturia.

One of them is an enlarged prostate, which can be a benign condition, with a normal prostate blood test ( normal PSA). You didn't mention whether you are having similar problems during the day or not? Specific questions your doctor would need an answer to would be how often you go during the day? Is it more than once an hour? Is the flow a decent strength stream of urine or would you say it is weak? Do you ever have difficulty starting to urinate or stopping urinating ( hesitancy or dribbling?) Do you ever feel like your bladder is empty then immediately feel then to go again? ( double voiding?) . How many times a night on average are you up to pass urine? is twice the usual?

To assess this further your GP should do a digital rectal examination to examine your prostate and check a blood test (which sounds like the one they have already done). Even if the blood test is normal that doesn't mean there is nothing wrong with your prostate, it could still be enlarged. If you have symptoms of an enalrged prostate I would suggest that they consider referring you to a urologist for further assessment, with or without trying some medication to try to stop the urgency and frequency or urination, while you are waiting to be seen. These drugs are called alpha-blockers and are very commonly used. If your prostate was definitely enlarged there are other tablets that urologists sometimes use too. Surgery is also an option.

The PSA blood test is not the only blood test your GP should check, a fasting blood glucose would hopefully rule out diabetes which can cause tiredness, weight loss, thirst, and polyuria ( passing large amounts of urine including at night). I would also check your kidney function just to make sure they are functioning normally.

In view of the tiredness, I would also ask for your thryoid and full blood count to be checked to make sure you are not anaemic or have an underactive thyroid.

So - I think you need to go back to your GP again, take a urine sample with you, explain that the symptoms have not gone away, clarify exactly what tests they did the last time, ( you may find some of these have been done already) and if you think that an enlarged prostate sounds likely based on the symptoms you have ask about a trial of medication and / or referral to a urologist.

Hope this helps.

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Yours faithfully,
The Thanks Doctor Team

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