INTRODUCTION:

Getting up in the middle of the night once in a while to urinate is normal. However, when the trips to the washroom become frequent, it is abnormal and is known as nocturia. This can affect the quality of life as it can lead to sleep disturbances, daytime sleepiness and in most cases, is associated with an underlying medical condition. Nocturia is a symptom commonly noticed in individuals with diabetes. The body removes the excess glucose from the blood through kidneys in the form of large volumes of urine. Apart from diabetes, another common cause for frequent urination during the night times in men is benign prostatic hyperplasia (BPH).

WHAT IS BENIGN PROSTATE HYPERPLASIA?

Prostate is a small gland located between the penis and bladder and is a part of the male reproductive system. Enlargement of the prostate gland, also known as benign prostate hyperplasia, is commonly noticed as men get older, usually above 50 years of age. The enlarged prostate puts pressure on the adjacent bladder wall and urethra (the tube through which urine comes out) and in return leads to frequent urge to urinate. It is important to remember that benign prostate hyperplasia is not a cancerous condition and neither does it increase the chances of prostate cancer.

SYMPTOMS:

When the enlarged prostate puts pressure and directly obstructs the urethra, it presents with symptoms such as

• difficulty in starting to urinate, even with pushing
• thin urine stream and many a times, interrupted
• trickling at the end of urination

The enlarged prostate can bring about bladder changes and cause:

• an urgent and strong desire to urinate
• frequent urination, usually more than eight times
• getting up frequently in the night to urinate
• unable to empty the bladder completely
• urine leaks – inability to control the bladder

DIAGNOSIS:

The diagnosis of benign prostate hyperplasia is based on a comprehensive medical history, a thorough physical examination and a few medical tests.

• While taking the medical history, the doctor will check on what symptoms are present, when they begin and their frequency. Presence of any urinary tract infection and medications taken are noted.
• Physical examination includes a digital rectal exam wherein the doctor slides his gloved lubricated finger through the patient’s rectum to examine that part of the prostate that lies close to rectum to check for any enlargement or tenderness.
• Medicaltests include analysis of urine sample in the lab, blood test, uroflowmetry (how the urine flows), urodynamic pressure (pressure on the bladder while urinating), cystoscopy (passing a tube-like instrument through the penis to look into the bladder and urethra) and ultrasound.

TREATMENT:

Individuals with mild symptoms can benefit from certain lifestyle changes such as reducing intake of liquids especially before bedtime and practicing certain pelvic floor muscle exercises that can help in better bladder control.A combination of medications can be prescribed to manage the symptoms better and to stop the growth of the prostate. If medications are ineffective, numerous minimally invasive procedures are available that will destroy the enlarged prostate tissue and reduce the pressure on bladder and urethra. These procedures include transurethral needle ablation, transurethral microwave thermotherapy, high-intensity focused ultrasound, transurethral electrovaporization and water-induced thermotherapy. When medications and minimally invasive procedures fail to work, symptoms aggravate and complications arise, surgery is recommended. Surgery is done to remove the enlarged prostate and the surgical options include transurethral resection of the prostate (TURP), laser surgery, open prostatectomy and transurethral incision of the prostate (TUIP).

COMPLICATIONS:

Men suffering with benign prostate hyperplasia for a long time can present with complications such as sudden inability to pass urine, infection in the urinary tract (UTIs), presence of blood in the urine, urinary stones and damage to the kidneys.

CONCLUSION:

Although frequent urination in the night is commonly associated with diabetes, it is important to not rule out urological causes such as benign prostate hyperplasia. Frequent urination, inability to control urine, urine leaks, etc. can signal an underlying urological condition, and if left undiagnosed and untreated, can lead to serious chronic conditions.
Chennai Kidney Care is regarded as one of the best kidney care hospitals in Chennai, performing numerous life-saving procedures in the field of urology. In a matter of a decade, the hospital’s scorecard boosts off a record of 979 patients treated with urological issues and 119 successful minimally invasive procedures performed.Chennai Kidney Care provides advanced facilities for a wide range of urological diseases pertaining to ureter, bladder, kidneys, prostate and male reproductive system with timely diagnosis and prompt treatment plan.