Frequent urge to urinate at night without and with pain: what to do and what to treat

Frequent urination at night without increasing the volume of urine is called nocturia, if at night liquids are released more than by day - nocturia. Two-thirds of all day trips to the toilet should be at day time. It is believed that for a healthy person one night urination is enough. The exception is the fact of taking diuretics, a large volume of drunk fluids or eaten fruits and vegetables that contain a lot of liquid, pregnancy. The causeless increase in night visits to the toilet signals a disease and requires specialist intervention.

[1], [2]

Causes of the frequent urination at night

In addition to the already mentioned physiological causes of frequent urination at night, these symptoms are caused by various diseases. Thus, nocturia is provoked:

• adenoma of the prostate;
• inflammation of the urinary organs;
• infections of the genital organs;
• nocturnal enuresis;
• hyperactive bladder;
• sugar or diabetes insipidus;
• neoplasms in the field of the urethra;
• kidney stones;
• reactive arthritis;
• a number of gynecological diseases;
• menopause in women;
• age incontinence.

Nocturia is summoned:

• chronic renal insufficiency;
• cirrhosis of the liver;
• heart failure.

[3], [4], [5]

Risk factors

The risk factors include hypothermia, causing cystitis, stress, neuroses, the first and third trimester of pregnancy, taking diuretics, and increasing the concentration of calcium in the urine.

[6], [7], [8], [9], [10]

Pathogenesis

The bladder contains 0.5-0.7 l of fluid, in a healthy state it is able to hold 0.3 L for 2-5 hours. At the heart of the pathogenesis of the disease is irritation of the receptors of the neck of the bladder and urethra, abundantly equipped with nerve endings. They act as a kind of sensor that works when the bladder is stretched as it is filled. The impact on the sensors as a result of any of the above causes a false signal to the brain, which is perceived as an "order" to contract muscles. At this time, there is a urge to urinate.

[11], [12], [13], [14]

Epidemiology

Statistics show that people who suffer frequent night trips to the toilet are quite a lot in the world. By the age of 60, half of the population is experiencing a similar problem, and by 80 all 90%. Enuresis, who also forces to get out of bed at night, is often too late, children are more likely (more than 90% of all carriers). Among men after 50 years, every fourth has a diagnosis of prostate adenoma. Appending to this group of pregnant women, people with various pathologies of the urinary system, the whole scale of epidemiology becomes evident.

[15], [16], [17], [18], [19], [20]

Symptoms

The symptoms of frequent urination at night, which should alert and force to consult a urologist are:

• the inability to cope with a strong urge and delay the emptying of the bladder;
• small amount of excreted urine;
• pain, pain when urinating;
• pain in the lower back and in the lower abdomen;
• a change in color, and sometimes an unpleasant smell of urine;
• blood or purulent fragments in the urine;
• increased body temperature;
• deterioration of the general condition;
• constant thirst, despite the large amount of fluid used;
• dryness of mucous membranes, weight loss;
• swelling, pale skin;
• pressure jumps (with kidney failure increases, with heart failure);
• Shortness of breath and inability to withstand physical activity.

Well and the first signs are causeless frequent desires to an emiction at night which arise not one night.

Frequent urination in women at night

May be explained by the banal reason for overdoing in eating watermelons, grapes, drinking soft drinks in the heat or tea in the cold. Also, the use of diuretics, for example, to reduce blood pressure, makes it necessary to remove fluid from the body in an increased volume. But if frequent night urges can not be explained by these factors, then it is necessary to understand the symptoms and find the cause of what is happening. With a normal water-mudflow balance, the volume of urine is 1.5-1.8 liters. To withdraw the liquid of their body enough ten urination, with the night time should not fall more than 2-3 for women in their ages, and for young - enough 1 time. Of course, each case is individual, each correction can be made by the features of the anatomical structure (bladder dilation, narrowing of the urethra, abnormalities in the musculoskeletal framework of the pelvis). If this is all right, then the reasons should be sought among the above. To them can be added inflammation of the ovaries, myoma and uterine prolapse. In the last two cases, frequent urges arise from pressure on the bladder. The age of the woman, the onset of menopause is associated with the gradual extinction of the functions of the ovaries, which means a decrease in the production of sex hormones, which in turn entails a decrease in the elasticity of the tissues. This leads to a weakening of the sphincters, the muscles that control the flow of urine leaving the bladder.

[21], [22]

Frequent urination at night with pregnancy

Another reason for frequent urination at night in women is pregnancy. This is especially evident in the first and third trimester of pregnancy. Together with the intensive growth of the fetus, the hormonal background changes, and the metabolism increases. With the onset of pregnancy in the body of a woman begins to develop a special hormone - chorionic gonadotropin, which increases urination. Also, through the placenta, the products of the fetus's vital activity enter the organism of the future mother, which are excreted through its urinary system. Another aspect of increasing urgency is the mechanical effect on the pelvic organs due to the growth of the fetus and the increase in the abdomen. In the second trimester of pregnancy, although the fetus has grown compared to the first, but its location shifts into the abdominal cavity, so pressure on the bladder weakens.

Frequent urination in men at night

Frequent urination in men at night can be considered a fact, when it occurs more often than once every 2 hours. Sometimes nighttime urges cause you to get up 10-15 times a night, which interferes with normal existence. In addition to the reasons inherent in both articles, there are purely masculine. These include prostatitis and adenoma. Prostatitis is an inflammation of the prostate gland that is located around the urethra and irritates the bladder receptors. With adenoma, the channel is channeled, creating an obstruction to the outflow of urine.

Frequent urination at night in the elderly

As a rule, it is associated with age-related changes: the elasticity of the bladder decreases, its shell thickens, the sphincter muscles weaken, the kidneys work worse and the urine is excreted in small doses. In addition to this, many other health problems accumulate with age. So, cardiovascular diseases, including hypertension, require daily intake of medicines - diuretics, which reduce pressure by removing fluid from the body. They can be felt by chronic infectious diseases of the urinary organs, and as immunity in old age is weakened and it results in various urological problems.

Frequent urination at night in children

Frequent urination of children at night does not always indicate a disease. The structure of the child and its organs is different from the adult. So, for example, the kidneys of the newborn are not completely formed yet, this process lasts several years. In the first months of life, the child urinates at least 25 times a day, by the year this figure is approximately 16 times, gradually decreasing with each lived year. After 6 years - an average of 5-6 times. At this age, a healthy child can sleep through the night without rising to go to the toilet, or after a lot of drinking or fruit to get up and several times a night. Frequent urge to urinate at night for no apparent reason should cause anxiety to parents if accompanied by pain and cuts during urination, aching pain in the lower back and lower abdomen, the appearance of a specific odor and color of urine, and sometimes sediment or flakes in it, a strong thirst for sufficient volumes of liquid being drunk. Spontaneous flow of urine in a child after 5 years (enuresis) is also an occasion to consult a specialist. Frequent urination without pain at night, even without the above symptoms may indicate the developmental defects of the genitourinary system, heart problems, neuroses and even mental illnesses.

Diagnostics of the frequent urination at night

The diagnosis of frequent urination at night is based on patient complaints, urinalysis and blood test results, and a variety of instrumental research opportunities. The specialist is found out the accompanying symptoms, the amount of fluid used, the medications taken.

The analysis of urine is examined for the number of leukocytes and erythrocytes, the presence of protein. An increase in white blood cells, a protein in the urine, indicates an inflammatory process of the urinary system - cystitis, pyelonephritis, urethritis. An increase in the level of erythrocytes indicates the presence of sand or stones in the kidneys. Protein can also signal glomerulonephritis - a lesion of the glomerulus of the kidneys. Urine culture is used to identify bacteria. If they are detected, a test is conducted on the sensitivity to antibiotics, which will be needed to treat the infection.

Daily urine collection is also carried out . Each portion is drained into one container, after which its volume is measured and examined for glucose, salt and protein. Increased glucose indicates diabetes mellitus. In diabetes insipid diabetes, there is a low specific gravity of urine in the kidneys. The patient also records the rhythm of urination and its single volume for several days, the decrease of which will allow the doctor to suspect neoplasms in the bladder or kidney stones. Changes in the biochemical analysis of blood can indicate renal failure or cirrhosis of the liver, and in the general analysis - about the presence of inflammation.

Instrumental diagnostics includes ultrasound of the bladder and kidneys. The study is performed with a filled bladder and emptied. In this case, there may be vices in the urinary system and kidney development, as well as inflammation. Actual and X-ray study. It requires preliminary preparation - purification of the intestine and introduction of a contrast agent into the vein 5 minutes before the procedure. In the pictures, thanks to him, the path of passage in the kidney and ureter will be imprinted.

Mikcionnaya cystourethrography also uses a contrast agent, but introduced through a catheter. This method determines the anomalies of the bladder and urethra, the degree of weakness of the sphincter.

Renoangiography and dynamic and static scintigraphy - use intravenously radiodiagnostic drug, its negative impact on the body is much less than X-rays, and the informativeness of the method is higher.

Cystoscopy - an optical device is inserted through the urethra into the bladder and examined.

[23], [24], [25], [26]

Differential diagnosis

The causes of frequent nighttime urination are many, so the task of differential diagnosis with similar symptoms is to determine the true for the correct treatment. So, in the case of the prostate gland, a PSA test (prostate-specific antigen) is used - a tumor marker for differentiation from a malignant tumor. Also resort to tissue biopsy.

[27], [28], [29]

Treatment of the frequent urination at night

Treatment of frequent urination at night is completely dependent on the diagnosis. The identification of diabetes mellitus will require bringing the blood sugar level to normal levels, and its constant monitoring. With urogenital infections, therapy is the use of antibiotics. Treatment of a hyperactive bladder requires the use of drugs that reduce the tone of the wall or relax the neck of its closure. Men suffering from prostate adenoma are prescribed drugs that help relax the muscles of the prostate gland, which reduces the pressure on her urine and widens her passage through the prostatic department.

Medications

Treatment of urinary tract infections (MVP) depends on the localization of the inflammation focus and their complexity. Uncomplicated inflammations are treated 3-5 days with fluoroquinolones : levofloxacin, ofloxacin, ciprofloxacin. With complicated infections, the course of treatment is 7-14 days.

Levofloxacin is a broad-spectrum antibiotic that acts on the membrane, the bacterial cell wall, destroying it. It is available in the form of tablets and a solution for injection. Tablets of 0.25 g once taken before meals or in between meals. With prostatitis treatment course is longer - 28 days, once a day for 0.5 g. Tablets are not chewed and washed down with a lot of water. The drug is contraindicated for children under 18 years of age, pregnant, during lactation, patients with epilepsy, with increased sensitivity to it. Side effect is possible in the form of nausea, vomiting, diarrhea, a sharp decrease in blood pressure, urticaria, bronchospasm, dizziness, drowsiness, general weakness.

Alternative drugs - cephalosporins II-IV generation : aksetil, cefixim, cefuroxime, cefoperazone, cefepime.

Cefuroxime is an antibiotic of the second generation, the mechanism of its action is the destruction of the cell wall of the bacterium, the form of the release is a tablet. Take after eating 125 mg twice a day. Duration of treatment - 7 days. There are side effects: nausea, abdominal pain, vomiting, diarrhea, confusion, jaundice. Contraindicated in renal failure, hypersensitivity to the drug.

For the treatment of prostatic adenoma, alpha-adrenoblockers are used . Here are some of them: terazosin, doxazosin, silodosin, alfuzosin.

Terazozin is an antihypertensive drug that expands venous and arterial vessels. Tablets are white, green, orange, light brown, depending on the dosage. The recommended dose for adenoma is 5-10 mg per day, starting with a smaller one and gradually increasing. The clinical effect occurs on average in two weeks. During treatment, it is necessary to control the diuresis. During the reception of the drug, weakness, nasal congestion, nausea, edema are possible. Has contraindications to people with an allergy to the components of the drug.

At night enuresis prescribe medications: priloygan, eliev, anafranil, saroten, amizol.

Priloygan is a preparation in the form of tablets, dragees and a solution for intramuscular injection with antidepressant, antidiuretic action. The therapeutic daily dose is calculated taking into account the age and weight. Children 6-8 years are prescribed 25 mg, 9-12 years - 25-50 mg, older than this age - 50-75 mg. The drug should be taken once a day for an hour before bedtime. The scheme can be changed if incontinence occurs early in the night. In this case, the dose is divided into two doses: in the middle of the day and before bedtime. If there is no improvement in a week, the dose is increased, but not more than 75 mg. The drug has contraindications for hypersensitivity, pregnancy, alcoholism, diseases of the cardiovascular system, epilepsy, in the elderly. Side effects are expressed in skin rashes, nausea, abdominal pain, decreased concentration, insomnia.

Vitamins

Vitamins make us healthier, more enduring, increase immunity, protecting against infections. You can buy in the pharmacy and take vitamin complexes, and you can saturate the body with a delicious mixture of various fruits: on the meat grinder, kuraga, nuts, lemon, raisins, prunes are added, honey is added. If frequent nighttime urination is caused by diabetes, then this recipe should not be used.

Physiotherapeutic treatment

In combination with medicamental therapy, physiotherapy is also used. So, with prostate adenoma, her massage is prescribed. To strengthen the muscles of the pelvis, bladder, urethra apply Kegel exercises, consisting in alternate compression and relaxation of the pelvic floor muscles. At various infections of urinary ways apply electrophoresis with medical products, UHF-therapy. Pyelonephritis, prostatitis, cystitis is treated with ozocerite warm compresses, which have a resolving, anti-inflammatory effect. In the period of exacerbations it can not be used. Physiotherapeutic methods, like laserotherapy, ultrasound, electrocutions are used for urolithiasis. These procedures relax the muscles of the urethra, have an anti-inflammatory effect. In case of extraction of stones by an operative method or crushing, mineral baths are shown. Physiotherapeutic methods are also used for uterine myomas. Contraindications to them is the large size of the tumor. Gynecologists can recommend radon and iodide-bromine baths, electrophoresis, magnetotherapy.

Alternative treatment

In the arsenal of alternative treatment for frequent nighttime urination baths, compresses, teas, infusions and tinctures. If the ailment is associated with inflammation of the urinary system, you can take warm baths, adding water to the infusion of plants (oat straw, hay, branches of pine chop, pour boiling water and insist).

To the bottom of the stomach apply a compress with a rubbed onion, keep at least an hour.

At an adenoma of a prostate apply applications with drawing of ointment. To prepare it take 50g of beeswax and vegetable oil, as well as 100g of pine rosin. All this is placed in a container and kept on fire all the time stirring, but not bringing to a boil. Cooled to 40 degrees ointment with a thin layer applied to the surface of the tissue. Apiproducts are also used to treat this disease. In the rectum after the defecation, injected candles made from propolis, royal jelly and cocoa butter in doses of 0.2 g, 0.01 g and 2 g, respectively.

[30], [31], [32]

Herbal Treatment

For the treatment of every disease that causes frequent night desires, the herbalists will have recipes, which, if not cured, can alleviate the condition. First of all, it is anti-inflammatory, antibacterial plants. Everyone knows the bark of an oak tree. To prepare a curative infusion it is necessary to take a tablespoon of bark on a glass of water, pour it with boiling water and leave to stand for an hour. The whole liquid should be drunk during the day in small portions of 1-2 teaspoons per one dose.

The same medicinal properties in such herbs as field horsetail, corn stigmas, bear ears, leaves and birch buds. They are used to treat inflammation of the urinary tract. The intake course lasts 2-4 weeks, then is interrupted for a week and repeated again. The infusion is prepared from the calculation of a spoonful of herbs for a glass of boiling water, left for 15-20 minutes on a fire or a water bath, then 1-2 hours infused. During the day one third of the glass is drunk. This is a diuretic, so trips to the toilet will become even more common, but the infection will be quickly removed from the body. In parallel, you need to replenish calcium, because Together with the liquid is derived and he.

For the treatment of myomas and other benign tumors, women prepare decoctions from the collections of the following herbs: chamomile, yarrow, motherwort, calendula, buckthorn. Two tablespoons of the mixture pour a half liter of water, bring to a boil. Insist 30 minutes. Take 150g in a warm form twice a day. The duration of the course is 15-30 days, after a one-week break you can repeat it.

Homeopathy

Homeopathy gives a good therapeutic effect in urological diseases, which provoke frequent urge to urinate. Here are some of them: blackberry buds, cannabis, equenzetum, parerier, etc.

To treat prostate adenoma, adenoma-gran is used. Produced in granules of 10 g. Every day 5 granules are taken under the tongue 20 minutes before meals or an hour after within 2 months, after a break of 7-10 days can be repeated. There are no side effects and contraindications.

Antidiabetic means - arsenic compio-diabetes. This drug is made in the form of drops and helps to avoid complications and stop the disease. Adults are assigned 8-10 drops per quarter of a glass of water twice a day. Side effects and contraindications are in case of individual drug intolerance. Concerning pregnancy studies have not been conducted.

With frequent urge to urinate, accompanied by pain and cuts, acute prostatitis of the prostate gland to men is prescribed homeopathic drug afal. In the morning and at night, without mixing with food, 2 tablets are put under the tongue and kept until completely dissolved. The course of treatment is long, up to 4 months. If necessary, increase the dose to 4 tablets. After a break in 1-4 months, treatment can be repeated. The drug is not prescribed for children and women. Side effects - in the form of allergic reactions.

To treat women with infectious diseases of the genitals, a drug called viburkol is used. The release form is a suppository. There were no contraindications and side effects. Dose intake - 1 pc. 3-4 times a day. The course of treatment is up to two weeks at the discretion of the doctor.

Operative treatment

A number of diagnoses causing frequent urination at night require surgical treatment. So, if the drug in combination with other methods does not bring relief in the case of prostate adenoma, one must resort to surgical intervention. Myoma of the uterus of large sizes with various complications, kidney stones more than 5 mm, causing frequent attacks - all this is an occasion to conduct surgical treatment. In any case, the doctor after a comprehensive examination will decide on the expediency of the operation.

Complications and consequences

The consequences and complications of frequent urination depend on the cause that prompted them. So, age incontinence, enuresis or a hyperactive bladder can reduce the quality of life, lead to anxiety, sleep disturbance, depression. With adenoma of the prostate, other tumors or kidney stones, everything can end up overlapping the ureter, which is already a direct threat to life. Untreated urinary tract infections can affect the kidneys, leading to kidney failure, and even complete organ death.

[33], [34], [35]

Prevention

Preventative measures that prevent an unpleasant symptom of frequent nighttime urination include measures to avoid hypothermia, healthy diet that excludes acute, fatty, restricting sweetness. Refusal to smoke and excessive intake of alcohol, exercise, hardening will improve the body and prevent many diseases, the consequences of which is such an unpleasant symptom.

Forecast

The prognosis of frequent urination at night is favorable in most cases with timely treatment of the underlying diagnosis causing nighttime urge. With age incontinence, the prognosis for life is favorable, and many modern care products will help preserve its quality.

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