How can someone overcome nocturia and reduced urine output?

Question

Hi doctor,

I suffer from nocturia, and I urinate four to nine times every night. I underwent transurethral resection of the prostate about eight years ago. I tried several anticholinergic drugs and did not succeed. After one year, I consulted a urologist, and he prescribed me Darifenacin 15 mg and Mirabegron 50 mg. This brought me a lot of relief.

I am currently experiencing the same problem. I am unable to sleep because I keep feeling like I need to urinate, even though not much urine comes out.

Please help.

Answer 1

Hi,

Welcome to icliniq.com.

Thank you for your query. I have gone through your reports (attachment removed to protect the patient's identity). It appears that you have symptoms predominantly on nocturnal frequency. I would like to know a few more details to answer your question better.

How is your daytime frequency?
Have you been evaluated with a frequency volume chart?
Is this sensation of incomplete urination absent in the daytime? For how long did you take Mirabegron?
Are you currently or previously on any diuretics?
What is the duration of your current problem?

Given that you have mentioned all the tests to check for blockage are normal. I would like to suggest performing a urinalysis to rule out any infection. The next step would be a frequency volume chart (FVC) to calculate the amount of daytime and nighttime urine volume.

Also, I would suggest that if you were symptomatically better with Mirabegron, then you can continue the same. If the results of the frequency volume chart show an increase in urine volume, then there are nasal sprays available to control it.

I would also suggest some lifestyle measures, which I think you would most likely be doing presently, like avoiding caffeinated drinks, reducing fluid intake at night, and trying to pass urine before going to bed. I understand that this is a troublesome problem, but it is not possible to find a quick fix for your symptoms. It usually takes some trials of all available medication and lifestyle measures to find out a treatment plan that best suits you.

Please follow up for further assistance.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

Thank you for your query.

It is good to hear that you have found a regimen that works for you. The mismatch of daytime and nighttime frequency is what prompted me to think you could have a nighttime increase in urine volume. If you have had it checked out, it's good, crossing off one thing from the possible causes. I would suggest you continue lifestyle measures too. In addition to the medication, they will play a small role in reducing symptoms too.

I hope you are satisfied with my answer.

For further queries, you can consult me at iCliniq. Thank you.