HomeAnswersUrologynocturia and nocturnal polyuriaI am unable to sleep at night because I suffer from nocturia despite taking medicines. Please help.

How can someone overcome nocturia and reduced urine output?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At June 2, 2023
Reviewed AtSeptember 14, 2023

Patient's Query

Hi doctor,

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

Answered by Dr. Karthik Rajan

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 a 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 to perform a urinalysis to rule out any infection. The next step would be a frequency volume chart (FVC) to calculate the amount of daytime and night time 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 shows an increase in urine volume, then there are nasal sprays available to control. I would also suggest some lifestyle measures which I think you would most likely be doing presently, like avoid caffeinated drinks, reduce fluid intake at night and try 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.

Patient's Query

Hi doctor,

Thank you for your reply.

My daytime frequency has been improved since I have been taking the combination of the tablets Darifenacin and Mirabegron. The sensation of incomplete urination is absent in the daytime. I have been taking Darifenacin together with Mirabegron for about 8 months and it came good results. I am not taking any diuretics at the moment. These agrevates my symptoms. My current problem started two weeks ago and I will see my doctor for a urinalysis or take antibiotics to eliminate any infection. I do not believe there is an increase in urine volume. I have done the lifestyle changes as a first line of action to no avail.

Answered by Dr. Karthik Rajan

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 night time frequency, is what prompted me to think you could have a night time increase in urine volume. If you have had it checked out its good, crossed off one thing from the possible causes.I would suggest you to continue lifestyle measures too. In addition to the medication as they will play a small role in reducing symptoms too.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Karthik Rajan
Dr. Karthik Rajan

Urology

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