Urine Stream: 2am v/ 2 pm

Posted , 13 users are following.

I've sort of alluded to this before here but never really had the question answered. Here's my problem:

Middle of the night. 2 a.m. (like right now). The stream is nowhere near what is in the middle of the day. i.e. It's as if the prostate has a grip on the pipeline such that 5 minutes or longer at the toilet (sitting, for the time involved), is standard -- and for a fairly paltry volume of urine intermittently released in short squirts.

2 hrs later, up again with the same routine.

DAYTIME, though, not so bad -- though hardly a gusher. At least the stream is there within seconds of the brain ordering it.

That's in the daytime.

But in the middle of the night awakened from sleep , good luck. Again, 5 minutes or longer of nothing...then a dribble...then nothing...then another dribble. And on and on.

Anyone experience similar? I am not TURP inclined right now and can handle the annoyance...but left wondering: Why daytime and nighttime differences? (My uro essentially dodges the question.)

Thanks for any input.

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  • Posted

    I I was wondering the same exact thing. I think it may be that I don't have a lot of urine in my bladder when it wakes me up in the middle of the night. but I'm not sure but what you described is exactly what is happening to me so you're not alone

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    • Posted

      Why is it nice to know I'm not alone 😃

      But if there is so little urine in the bladder in the middle of the night as you suggest, why the pain until it is released? My other theory is that if you sleep on your stomach (which I do) it puts pressure on the bladder. Working now on losing weight to see if that's my problem. I am 5'11" and 240 with, yes, a moderate belly to press on as I sleep. If I weighed 180 as I did in college, perhaps the problem goes away. I am, btw, age 72.

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    • Posted

      Owen,

      Sleeping on your stomach can pinch the nerves in your low back, ask a chiropractor or doctor about it.

      I also have a low back problem, degenerated L5 disk and L4, L3 , are not the best. I have always wondered if that has something to do with my urinary difficulties. It seems that the bladder may not get as strong a signal to empty.

      Thomas

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  • Posted

    Owen,

    Some ideas for you:

    1. standing up produces a stronger urine flow for me than sitting down
    2. when I stand up in front of the toilet I lean forward against the wall to relax and this helps the flow
    3. to clear my bladder I pee, then wait a few minutes, then try again, then sometimes try a third time. This helps to clear the retention and allows me to sleep longer before getting up again
    4. if you are not already on tamsulosin, give it a try. It can relax the tissues and help you
    5. consider that your issues are not prostate but bladder neck constriction. We have had some recent discussions on this forum about this. Many here (including myself) were treated for BPH with various techniques and nothing helped. So, it's possible the the issue is a narrowing of the bladder neck that restricts urine flow. You have to get tested and scoped for this. Look up on the net PBNO - primary bladder neck obstruction.
    6. try CIC. Some here have been successful and getting relief by learning how to self cath, especially before bed. This in not for everyone. Perhaps you have tried this, perhaps not.

    I get up 5-6 times per night to pee - I have gotten used to it, but the nocturia is a challenge.

    My best,

    Tom

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    • Posted

      Hello All

      Yes it could be the bladder neck but it could also be the internal sphincter. I have a problem with my external sphincter. I take Vesicare to help it relax.

      I do not stand that much. When I had a catheter in one of the time I needed one. They put in and did not give it enough lee way. It pulled down on my penis and it made the pee hole longer. So if I pee standing up it sprays like a fan.

      Told my doctor and he said he could put a couple of stitches to close it mor. I told him that was ok no problem.

      I have a thing that I want to run by you guys if anyone has had this problem. This has been going on for maybe 6 to 8 month. Really was not paying attention could be longer. When I get up in the morning. I go to the bathroom. I feel I have done good. I will sit for about 10 minutes or so. Then I get up to get ready to get dressed and go out. I put my sock on and pants. I feel I have to go. So I try maybe one squirt. I finish getting dressed and I feel I have to go again. So I sit down and maybe 15 - 20 second one squirt again. Now I have gone 3 times within maybe 45 minutes. Heading out the door I get that feeling again. I go set down don't want to take a chance. But this time nothing.

      This does not happen to me staying home. Once I have gone in the morning if I am staying home I'm good for 6 or 7 hours I don't know if it has something about going out or getting dressed. Don't know. Please let me know. Take care...........Ken

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    • Posted

      Very interesting Tom.

      You say leaning against the wall makes it easier. Me too! You know what also makes it easier? Going outside on the deck on a moderately cool middle-of-the night and enjoying an almost instant response! Weird.

      But maybe the sitting is the issue, as you suggest.

      And yes, "double voiding" I think it's called. It does provide a feeling of being fully emptied.

      I am on alfuzosin -- a variation on tamsulosin therapy. I have tried with and without alfuzosin and with alfuzosin definitely "relaxes" to an extent -- an unfortunately minimal extent. Tamsulosin has RE as a side effect and the therapeutic difference is not appreciable enough.

      PBNO -- thanks for the thought. I will ask my uro.

      As for CIC -- it is something I dread after encounters with the cystoscopy wand. Last, last resort.

      Thanks very much for the thoughts.

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  • Posted

    The fuller your bladder, the more pressure it puts on (what sounds like) an already enlarged prostate. How often are you going during your waking hours? If you are going every two hours at night but every hour during they day, your bladder will be less full. Have you had any tests done?

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    • Posted

      Thanks for the thoughts trustme . To reply:

      Tests: cystoscopy to confirm no bladder cancer; PSA is low normal for my age @2.4; perhaps most importantly, bladder scan after voiding shows minimal urine remaining.

      Frequency in waking hours is about every two hours...though I drink considerable fluids during the waking time. I cup of coffee to start, then maybe 32 oz of water over a 5-hour work shift period.

      Example: it now 8:30 PM and I just violated a cardinal rule of no drink after 7. But just awoke from an after-work nap (I am 72 and work a physical job not for the money but for the exercise) and consumed approximately 1 quart of skim milk with dinner. I will likely go to bed for the night around 11 and be summoned to the toilet once every two hours in the overnight -- even after a full voiding before bed. (I consumed more than usual fluid tonight -- it being a Friday and no work tomorrow. But I typically consume at least 16 ounces of fluid in the dinner period circa 6-7 pm.

      So the volume of consumed fluids in my system is certainly considerable at any given hour. But again -- the original question: why is urination such a stop-and-go process in the nighttime and not in the daytime. It's as if, in the night, the prostate has a strangle hold on my urethra. But not so bad a grip in the day. Am sometimes tempted to limit fluids to three 8 oz cups in a 24 hour period but, thus far, it's too much to ask.

      Thanks to all for the thoughtful comments!

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    • Posted

      P.S. Uro says --and has said for years -- that dri suggests my prostate is not enlarged. I don't believe that, but...

      I wonder whether an MRI of my prostate would help in any way. Anyone ever had that?

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    • Posted

      Another P.S. Make that "consumed approximately 1.5 quarts of skim milk at dinner". I love milk. Been my addiction since a kid.

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    • Posted

      Owen,

      Try cutting back on liquids in the afternoon. My best nights are when I work in the yard all afternoon, and dont drink like I do when I'm in the office .

      BTW, last night 1:30am I had a rough time going. 5:30 a little better, 8:30 still better yet. 1am to 3am always the worst time for me.

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    • Posted

      Our schedules and difficulties are all but identical. Good advice, yours, on cutting in the afternoon. But for me, there is always evening as the big temptation.

      Some people smoke. My smoke is my drink -- and not alcohol. Everything but alcohol -- milk, juices, water. It will be a tough habit to alter but I must try. Thanks.

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  • Posted

    Same issue for me. no one seems to know why its worse at night.

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    • Posted

      Timothy,

      A couple of years ago I measured my urine flow over a period of a few days, and found that at night I was producing about 75ml/hr, but during the day 45ml/hr. I concluded that during the day I was sweating off and exhaling off water, but at night not so much.

      About the strength of the stream (rate of flow) - easy to measure. Just pee into a measuring beaker and count the seconds. My flow is very low - about 3/4ml second at best. "Normal" is about 20-21ml/second from what I have read. I am thankful I have any flow at all, so if it takes me a minute or two to empty my bladder that's OK with me. I went through a 5 week period a few years ago after radiation for prostate cancer when my prostate was swollen and I had no flow - was on Foley catheters until I could pee on my own. So, I will never take peeing for granted again.

      Tom

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