worried about night time symptoms

Posted , 7 users are following.

I'm 34, male and for more than 2 months now I've been experiencing some strange, vague symptoms which are actually hard to describe as there is no pain or anything severe physically.  

It's like a slight sensation of fullness with a very slight urge to pee which is more prominent at night and can disturb my sleep. I wake up around 3/4 am on and off for these 2 months with that slight sensation. Last few nights I've woken up with it but then it seems to ease up fairly quickly the longer I stay awake.  However, my actual urination frequency is largely normal, that's volumes (about 2-2.5l a day) and number of times I'm going (4-5 times/day), it's just that at night time I keep waking up at these odd times even though I didn't drink anything before bed.

I've never had pain or burning or straining when peeing and there's no pain whatsoever anywhere else.

I've had urianalysis samples done 4 times, all normal, tested my blood glucose level several times using home testing kits before/after meals and that's normal too. I then finally had a DRE and to my surprise, the doctor said it was enlarged however it was very smooth and normal in that regard.  I didn't expect someone my age to have this but the doctor wasn't overly concerned about it and said it's not abnormal and this can happen and it's nothing hugely to worry about. Nevertheless I asked for a PSA.

Am I right in thinking that the smoothness and surface/texture of the prostate is more important than the actual size? 

He thinks that my symptoms are more likely due to a slight over-active bladder than anything else. 

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  • Posted

    Unless your sleep disturbance is very bothersome, there is no need to think much action is required or that anything  anything sinister is happening or has been missed. The slight prostate enlargement is probably the cause of these symptoms. If it doesn't wake you too much to get out of bed and urinate, it may be better to do so than keeping an unvoided bladder till morning. Unfortunately, I imagine you will eventually be getting up because you have to void several times a night (as I have had to do for the past 10 years since I was in my 50s). The result of incomplete voiding for me is that I have been plagued by a lot of urine infections due to how the urine festers in the bladder when it has remained there too long.

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    • Posted

      If it is prostate enlargement then that is extremely depressing to get it at my age which is why it bothers me so much. It's strange though because I haven't had any issues with actual voiding and urine flow, both of which has been normal and the same all my life. So surely, this would get worse even over the last couple of months? I would have noticed at least some straining or pain?  

      Only thing I do notice other than the night time waking is the slight urges to urinate when I'm in the shower and contact with hot water. For some reason I'll keep peeing out drops as I'm showering which I've never done before. This has been happening on and off for a while now. 

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    • Posted

      I totally agree with you. In my case I get up three to four times and I have become accustom to it. It happens with age. When you start having pain or feeling a lump in your rectum then you need to get checked out right away. It doesn't hurt to have PSA tests every two years it may help ease your mind, but I read an article that stated that as many as 15 out of 100 men with a PSA less than 1 have Prostate cancer and that is why I am worried because I have symptoms of PC, but I take Prednisone and it has shown to reduce PSA levels by as much as 80% in some. My PSA was only .24 so I really shouldn't worry. Just keep an eye on things and if symptoms get worse then get it checked.

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  • Posted

    It appears to be the enlargement of the Prostate that is the likely cause, which are your age is quite early so a PSA test is wise, once you have the results for that you may no more. PSA isn't the most sensitive of tests and can be affected by many things unrelated to cancer but the Doctor's will advise on that. If it turns out to be the start of BPH it is my view, I'm not a Doctor just someone who has gone throught it, you should investigate the suitability of a PAE (Prostate Artery Embolisation). The reason I give for this is that symptoms of BPH are often put up with over many years. The problem with this is your bladder has to start working harder to push urine past the narrowing urether. This is a problem, as the bladder becomes stretched and less able to void fully. Catching this early could mean a better long term outcome for you. I wish it had been available when I first started to experience the symptoms, I'm convinced it would have made a big difference to the course of my own BPH.

    You are right that the smoothness and surface texture is more important than actual size, but BPH has it's own problems to contend with too. Catch it early and it might just mitigate those to your much greater satisfaction.

    Clearly there may well be other reasons so your Doctor is right to not rush to judgement and other tests need to be carried out to narrow the cause. If it is straight forward BPH then the above may well apply.

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    • Posted

      How can you know from the PSA though what is really going on? I thought they just give you a score and that's it. Can you tell from just a PSA, what the root cause is i.e. BPH, infection, cancer etc.?

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  • Posted

    PSA doesn't tell you what is wrong - just that there is something. It could be Benign Enlargement, cancer, infection, injury. Even ejaculating before the blood is taken can raise the level. The main use is to be able to compare results, usually 6 months apart, and form a picture over time as to what might be developing or improving.

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  • Posted

    I have had symptoms of BPH now since I was 45 and now I am 49 and it has gotten worse. Don't put too much stock in PSA testing. I had a PSA test, well I have been tested every year since I was 42 and to my surprise my PSA has declined since I was 42. The doctor confirmed I have BPH, but my PSA was .33 when I was 42 and the last one I had was .24 so go figure. I think this test isn't always very accurate. It doesn't hurt to get one, but it may not always give you the answers you are looking for. I have terrible symptoms, but I blew my doctors mind, because she was ready to do a Biopsy thinking my PSA was going to be high. I was happy, I don't want a biopsy.

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    • Posted

      To ru58350 : My PSA at agee 49 was 16.92 but a few days later 9.66.  This was after what I now know to be suspected bacterial prostatis, after years of presumed chronic non-bacterial prostatitis where I got up to pee 2 or 3 times a night, and flow was becoming less good.  Only went to uro via doc after the sudden bacterial prostatis? which had me peeing up to 10 times a night and never feeling empty.  That was annoying and unsettling.  ALso had alternative % free PSA test, 4% then 5%, bad readings.  So (by now worried !) had 3-T MPMRI, came back with 4 out of 5 on liekhart scale possible P Ca in one area but might just be inflammation.  3-T MPMRI? like PSA is only reliable when you get the GOOD result, the BAD result is not reliable.  Off to transperineal MRI-targetted biopsy, and lo! no cancer just inflammation.  (a modest 13 cores done).  Cystocopy showed (still tail end of acute bacterial prostatitis) prostate bulging up on bottom of bladder where the empty/full sensor is.  Agreed to HOLEP, leading to retrograde ejaculation which a 34 year old woudn't want (= unreliably infertile).  Holep chips tested for cancer, none present, just inflammation.  I now sleep through or pee just once.  A good result.  But in your case, I wouldn't go for urolift in case it doesn't work/doesn't last long enough; try PAE or Rezum.  Success rate for all these alternatives is substantially lower than Holep, TURP or PVP greenlight, but at your age it's worth throwing the dice on them.  You can ask for ejaculation-sparing holep, at least one British urologist (mine) now offers them (didn't  in June 2016 when I had mine done), of course no work on top of prostate means the cure may be less good I guess (might still leave it bulging up into bladder, so you have good flow after, but still have the frequency issue ... you didn't mention flow just frequency). 

      ?Also before surgery, do try training your bladder by hanging on longer before peeing in day time, this at your age will do no harm and if it is just a bladder issue, that might re-calibrate the bladder. 

      ?If you ever take flowmax even just one pill, later in life cataract surgery may be harder as binds hard to A1 receptor in both irises, for life.  And it gives the retrograde thing for many (but back to normal when you come off it, as it were)

      To ?Craig : super-low PSA numbers, that's great.  Rules out PCa as explanator and saves you all the bother I had.  Normal as you know is 0.7, only above 2.5 at your age is actionable. 

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    • Posted

      I seem to have issues after sex. Sometimes I have to stand over the toilet for over an hour as urine keeps dribbling out and I get what I think is pain. It is an odd feeling for sure. I have also had pain in my back and in my groin. It is terrible but I have had enough tests and tried many medications. My PSA is low, but I could still have PC, but I doubt it. To RU if I were having your symptoms I wouldn't really do anything about it, but that is me and I have been having a lot of symptoms, so I would think I was getting better if I had to pee once at night. If it gets worse and you get up several times or you have pain of any type it is time to get serious about it. I guess you need to figure out how long it has been going on and do you think it may get better? Are some nights worse than others? If so what did you do differently before bed? Did you drink  an alcoholic beverage? There can be many things causing it. You just may be getting the early symptoms of BPH. Does PC run in your family? If so then you need to be checked with a PSA test every so often. Just be careful ok, but don't get too worried about it. 

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  • Posted

    Are you constipated often ? It may be the cause. Otherwise, just wait and see. At this point, any suggestions for surgeries are irresponsible. Hank
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  • Posted

    As well as alcohol, also consider if caffeine could be an exacerbating factor (by, cutting it out).  Spicy food also.  No evidence these were relevant for me, but some men say that for them, they are.  Do try daytime bladder training (when feel need to pee, don't if you are able, the feeling tends to subside, wait until you REALLY need to go.  Also occasionally check volume in a jug, orjust in a 220 ml disposable cup - flip over when full and continue; make small allowance for the loss when flipping.  If it's 200 ml you're almost certainly going too often.  700 ml - remarkable (but harmless).  500 ml - good.  300 to 450 - probably typical for most men (I seem to be around 300 to 350, can hit 500 if I really try). 

    ?To measure capacity of disposable cup - put on scales; zero them; pour in water. Specific gravity of water is 1, so 1 gramme is 1 cc exactly. 

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    • Posted

      Hi Paul, 

      Thanks for your thoughts. Infact I have tried holding it in more and sometimes it does indeed subside. I think the main concern for me is that my whole life until basically the last two months I've always had a very strong bladder. Most of the time I only need to go a few times a day and that's after many cups of tea. I do drink alot of green tea maybe around 2-3l a day, occasionally more for many years and never had an issue.  So I suppose maybe things can change....

      Now I have actually been recording my voids using a 500ml plastic bottle.

      Most of the time when I NEED to go - as in WHEN I get a real urge I'm urinating around 600ml at a time (after drinking around 2l possibly) - urine colour is always clear, diluted.

      Other times 350-500ml with a mild urge - urine colour yellowish

      Overnight, or the times I get a slight urge at night it's around 250-300ml - urine colour very yellow  concentrated. 

      So yeah I think my bladder is still capable of holding in alot of urine, it's just that I find occasionally I'll urinate around say 500ml at once and then an hour later I'll urinate another 300-400ml even though I hardly drunk anything in between. So maybe some slight urine retention. 

      Doctor as I said, remarked it could be just an overactive bladder which would explain the intermittent symptoms I suppose. 

       

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    • Posted

      600 ml is a proper good void.  You beat my highest score, even after the HOLEP.  It sounds annoying, I am out of ideas now as to the answer.  Green tea is high in antioxidants but I THINK (you should check) that it has less caffeine. 
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    • Posted

      Thanks Paul. Yeah I'm trying to cut down on green tea now.

      I guess I'm still trying to figure out why I'm still getting these mild symptoms. For example, the last few days now, I've woken up around 1-2am with this strange sensation of wanting to pee, a mild tightness possibly down there, however it's still not strong enough to actually make me go pee. That's because I know that my bladder is never actually full at this point. I empty my bladder before bed obviously. For me, I can hold upto around 700ml until I really feel the urge to go. 

      However the odd thing is that I'll fall back to sleep only to wake up again around 4-5am with that urge still present. But then if I just lie in bed or use my phone or whatever it seems to disappear more or less, within minutes. It's literally just present when it wakes me up and that's it. So maybe it's just nothing but this is disturbing my sleep I guess.  

      So I guess I'm trying to work out is why I'm waking up in the first place like this.

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