Medical Forum / General / General / January 2006
Uncontrolled night-time urination
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John Curtiss - 03 Jan 2006 17:25 GMT Sorry for the cross-posting, folks - I will drop the newsgroups where I don't get any replies.
I have a relative with a night-time urination problem and am looking for some good advice.
He is mid-70's and has Parkinson's with dementia now coming on pretty bad at night. He is waking up every 2 hours to either urinate but most of the time he uses the Depends. Most of the time this keeps his wife up all night since he wakes her up as well.
I don't go with him to the doctor, so I have to rely on what his wife tells me. The GP gave him some kind of sleeping medicine and says that "he is not a candidate for surgery." I can't get her to ask him what that means. Anyone here know?
Some other questions I have are....
1 - Should he see a urologist? His GP says he doesn't need to see one.
2 - How can I find out if their GP has any complaints or problems? He is a member of AMA but I don't see a way to check there.
Thanks.
John
J. Davidson - 03 Jan 2006 21:52 GMT John, I remember googling disciplined doctors or something and it brought up the info I needed. Also, if you google AMA physician search and go through the steps I believe you can find your info here too. good luck Jackie
> Sorry for the cross-posting, folks - I will drop the newsgroups where I > don't get any replies. [quoted text clipped - 22 lines] > > John Fred - 04 Jan 2006 06:16 GMT Thank you, Jackie.
> John, I remember googling disciplined doctors or something and it brought up > the info I needed. Also, if you google AMA physician search and go through [quoted text clipped - 31 lines] > > > > John Jason - 04 Jan 2006 05:41 GMT > Sorry for the cross-posting, folks - I will drop the newsgroups where I > don't get any replies. [quoted text clipped - 22 lines] > > John John, I am not a doctor. Yes, your relative should see a urologist. You may want to do a google search related to Prostrate and also Enlarged Prostrate. It's a common problem in men over the age of 60. One of the symptoms according to my medical book is "increased urinary urgency and frequency, especially at night". Jason
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Fred - 04 Jan 2006 06:16 GMT Thanks, Jason. His doctor says "he's not a candidate for surgery." Any idea on why the doctor might say that? He's in the advanced stages of Parkinsons but otherwise has a strong body and is in good physical health.
> > Sorry for the cross-posting, folks - I will drop the newsgroups where I > > don't get any replies. [quoted text clipped - 30 lines] > especially at night". > Jason David Wright - 05 Jan 2006 05:24 GMT >Thanks, Jason. His doctor says "he's not a candidate for surgery." Any >idea on why the doctor might say that? He's in the advanced stages of >Parkinsons but otherwise has a strong body and is in good physical health. It is not a good idea to ask medical advice of Jason. He might give you some. In general, taking it is unwise. As he said, he is not a doctor. He's not any kind of medical professional at all, or even a skilled amateur. For example, he seems unaware of the difference between "prostate" and "prostrate."
-- David Wright :: alphabeta at prodigy.net These are my opinions only, but they're almost always correct. "If you can't say something nice, then sit next to me." -- Alice Roosevelt Longworth
>> > Sorry for the cross-posting, folks - I will drop the newsgroups where I >> > don't get any replies. [quoted text clipped - 35 lines] >> especially at night". >> Jason Jason - 05 Jan 2006 06:30 GMT > Thanks, Jason. His doctor says "he's not a candidate for surgery." Any > idea on why the doctor might say that? He's in the advanced stages of > Parkinsons but otherwise has a strong body and is in good physical health. I don't know. I seem to recall one doctor saying that there is a greater risk when elderly people are operated on. Doctors don't like to take changes related to operating on "high risk" patients. The doctor could solve the problem by referring your friend to a urologist. Urologists do these sorts of surgeries on a regular basis and may do the surgery. One of risks of this surgery is incontinence. The doctor might have other reasons--ask him. Jason
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Fred - 05 Jan 2006 06:53 GMT I see. Thanks again.
> > Thanks, Jason. His doctor says "he's not a candidate for surgery." Any > > idea on why the doctor might say that? He's in the advanced stages of [quoted text clipped - 8 lines] > reasons--ask him. > Jason Twittering One - 05 Jan 2006 05:35 GMT "Banqueting With her in her wind-walled palace, Underneath her azured dais, Quaffing, as your taintless way is, From a chalice Lucent-weeping out of the dayspring." So it was done: I in their delicate fellowship was one ~ Drew the bolt of Nature's secrecies."
~ Francis Thompson,
>From "The Hound of Heaven" nospam@aol.com - 05 Jan 2006 17:10 GMT >Sorry for the cross-posting, folks - I will drop the newsgroups where I >don't get any replies. [quoted text clipped - 22 lines] > >John His GP should have checked him for prostate enlargement. It is possible his prostate is fine. Have you asked about that?
He has parkinsons and dementia. You should make sure he has good insurance because he most likely will not get better. And watch his reactions to the sleeping medications because they can cause problems which are worse than insomnia.
Speaking from experience.
Ora
ironjustice@aol.com - 05 Jan 2006 19:06 GMT I would look into erythrocytosis / polycythemia ..
An increase in iron in the body has been shown to produce increased red blood cells .. and increased red blood cells have been linked to increased vasopressin ..
Increased vasopressin leads to polyuria ..
Decreasing red blood cell count / treating erythrocytosis leads to decreased incontinence ..
Coincidentally Parkinsons' recently has been found to have some significant recovery by elimination of red meat {high iron] and inclusion of riboflavin {iron chelator] in the treatment regimen.
Excessive voiding is evidence of a impairment of vasopressin and impairment of vasopressin is associated with .. excess .. red blood cells .. causing .. polyuria / excess voiding ..
J Vet Intern Med 1997 Sep-Oct;11(5):300-3
Polyuria and polydipsia and disturbed vasopressin release in 2 dogs with secondary polycythemia.
van Vonderen IK, Meyer HP, Kraus JS, Kooistra HS
Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, The Netherlands.
In dogs, secondary polycythemia (SP) may be associated with polyuria and polydipsia (PU/PD). The pathogenesis of this PU/PD has not yet been explained. We hypothesized that hyperviscosity and increased blood volume in SP might affect vasopressin (VP) release, resulting in PU/PD. This hypothesis was tested in 2 dogs with SP caused by renal neoplasia and PU/PD. Osmoregulation of VP release was studied by a modified water deprivation test and by investigating the VP response to hypertonic saline infusion. Water deprivation test results were consistent with an inability to produce concentrated urine despite increasing plasma osmolality. During hypertonic saline infusion, the osmotic threshold of VP release was markedly increased in both dogs, resulting in a delayed VP response to increasing plasma osmolality. The sensitivity of VP release was low normal in both dogs. We conclude that blood hyperviscosity and increased blood volume led to impaired VP release and polyuria.
PMID: 9348498, UI: 98009104
_________________________________________________________________
Coincidentally .. again .. diabetic have JUST been found to be .. hyperviscous .. and what do THEY .. have .. ?
Increased urination .. ?
Yep ..
Who loves ya. Tom..
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Fred - 05 Jan 2006 21:14 GMT Many thanks for the info!
> I would look into erythrocytosis / polycythemia .. > [quoted text clipped - 67 lines] > DEAD PEOPLE WALKING > http://pages.ivillage.com/ironjustice/deadpeoplewalking kumar - 13 Jan 2006 08:11 GMT Can't we relate Uncontrolled and excess night-time urination with acidosis/acidic urine? Can't we relate excess iron digestion so absorption with hyper gastric acid, heme based foods and with iron supplements? Can't we relate excess iron with acidosis?
> I would look into erythrocytosis / polycythemia .. > [quoted text clipped - 67 lines] > DEAD PEOPLE WALKING > http://pages.ivillage.com/ironjustice/deadpeoplewalking REP - 13 Jan 2006 11:06 GMT > Can't we relate Uncontrolled and excess night-time urination with > acidosis/acidic urine? Anecdotally speaking (and probably in general as well) no. While anecdote is not the plural of data, I have a urinary pH of 4.5 - 5.5 and do not experience any, let alone excess, nighttime urination - and I take 60mg Lasix before retiring!
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kumar - 13 Jan 2006 11:45 GMT Then what can make one to urinate more and uncontrolled in night? I doubt that quantity of urine is always relevant to it? Can it be some problem in contracted/relaxed condition of bladder?
> > Can't we relate Uncontrolled and excess night-time urination with > > acidosis/acidic urine? [quoted text clipped - 7 lines] > "Did Father shoot him? I will eat Grandfather for dinner." > - Helen Keller, on learning of the death of her grandfather Jason - 13 Jan 2006 16:55 GMT > Then what can make one to urinate more and uncontrolled in night? I > doubt that quantity of urine is always relevant to it? Can it be some > problem in contracted/relaxed condition of bladder? Do you have this medical problem? I suggest that you call your doctor and request a complete physical exam. Prepare a list of questions and ask the doctor to answer those questions. For example, if you urinate many times during the night, it could the result of several different medical problems such as an enlarged prostate. A doctor can easily determine the reason you urinate several times each night.
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Fred - 15 Jan 2006 08:40 GMT The relative I'm working with told the Dr that he hadn't had a prostate exam in 3 years, so the Dr gave him a rectal exam on the spot.
Stupid question probably -- was this the right exam? I thought a prostate exam was unrelated to rectal exam
John
> > Then what can make one to urinate more and uncontrolled in night? I > > doubt that quantity of urine is always relevant to it? Can it be some [quoted text clipped - 7 lines] > an enlarged prostate. A doctor can easily determine the reason you urinate > several times each night. Mxsmanic - 15 Jan 2006 10:37 GMT > The relative I'm working with told the Dr that he hadn't had a prostate exam > in 3 years, so the Dr gave him a rectal exam on the spot. > > Stupid question probably -- was this the right exam? I thought a prostate > exam was unrelated to rectal exam A digital rectal examination is a prostate examination. The prostate is very near the rectum, so a doctor can feel the state of the prostate simply by inserting a finger in the rectum and palpate the prostate through the rectal wall. This is precise enough to allow the doctor to get a pretty fair idea of the gross state of the prostate. Certainly if it is enlarged or badly diseased it can often be felt.
A PSA blood test can also be used to screen for prostate cancer. It just screens for cancer, however; it doesn't say much about benign enlargement of the prostate (for that, the DRE is simple and easy).
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Fred - 16 Jan 2006 07:41 GMT Thanks very much!!
> > The relative I'm working with told the Dr that he hadn't had a prostate exam > > in 3 years, so the Dr gave him a rectal exam on the spot. [quoted text clipped - 12 lines] > just screens for cancer, however; it doesn't say much about benign > enlargement of the prostate (for that, the DRE is simple and easy). Mxsmanic - 13 Jan 2006 20:58 GMT > Then what can make one to urinate more and uncontrolled in night? Increased production of urine, decreased capacity of the bladder, or problems with the detrusor or the parts of the nervous system that interact with it.
> I doubt that quantity of urine is always relevant to it? Correct. See above.
> Can it be some problem in contracted/relaxed condition of bladder? Yes. Problems with the detrusor can produce unusually frequent or infrequent urination, up to and including incontinence and retention leading to stagnation and infection. Problems with the nerves interacting with the detrusor can have a similar effect.
Physical encroachment on the bladder (as during pregnancy) can reduce its useful capacity and increase the frequency of urination.
Note that while some conditions may increase the _frequency_ of urination, they may not necessarily increase the _volume_ of urine excreted.
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kumar - 16 Jan 2006 12:27 GMT Urination - excessive at night http://www.nlm.nih.gov/medlineplus/ency/article/003141.htm
The above link gives lot f informations in this respect.
> > Then what can make one to urinate more and uncontrolled in night? > [quoted text clipped - 19 lines] > urination, they may not necessarily increase the _volume_ of urine > excreted. Mxsmanic - 16 Jan 2006 12:36 GMT > Urination - excessive at night > http://www.nlm.nih.gov/medlineplus/ency/article/003141.htm > > The above link gives lot f informations in this respect. Yes, although mostly just the same things that have already been discussed here.
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John Curtiss - 17 Jan 2006 10:38 GMT Thanks for the link!
> Urination - excessive at night > http://www.nlm.nih.gov/medlineplus/ency/article/003141.htm [quoted text clipped - 24 lines] > > urination, they may not necessarily increase the _volume_ of urine > > excreted. PF Riley - 12 Jan 2006 04:13 GMT >Sorry for the cross-posting, folks - I will drop the newsgroups where I >don't get any replies. [quoted text clipped - 11 lines] >a candidate for surgery." I can't get her to ask him what that means. >Anyone here know? Remember rule #1: Never believe what a patient tells you their doctor said.
Why don't you get the relative to sign a release form for you to talk to the doctor yourself? I'm sure you would be much more satisfied than soliciting useless advice off Usenet.
PF
Fred - 12 Jan 2006 08:05 GMT "PF Riley" <pfriley@watt-not.com> wrote in message
> Why don't you get the relative to sign a release form for you to talk > to the doctor yourself? I'm sure you would be much more satisfied than > soliciting useless advice off Usenet. Understood and agree, but it's a delicate situation. And I'm not looking for diagnoses here - just things to check into and other general info. I would not recommend anyone take a posting for the truth, but the are a great source of information.
What I have gotten from helpful folks here far surpasses anything I have heard from friends, relatives, support groups or any of the govt agencies - fed, state & local. Because of usenet postings, we located an adult day care center, assisted living facilities, doctor sources, details about medicine, etc., etc. - the list goes on.
It has pointed me to many, many avenues that I would have otherwise missed.
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