Recently I attended the American Urology Association Annual Meeting in Washington DC and learned many new developments in basic research and clinical studies related to bladder control problems. I will be selectively reporting information I think you may find interesting. Let’s call it Frontline Report.

Nocturia – Frequent Nighttime Urination

Frequent nighttime urination, or nocturia- the need to urinate more than two times a night, is mostly related to aging.

But why?

An enlarged prostate seems to be the common culprit for many men.  However, studies have shown that for a majority of the men with enlarged prostate, nocturia remains to be a problem even after their prostate surgery. In addition, many men who have no prostate issues are also experiencing the annoying nocturia problems.

Now, how about women? No prostate! But millions of women have nocturia issues.    

Studies have shown that for both men and women 50 years and older, the average number for nighttime urination is three times. This number tends to increase as people get older.

But why?

According to Dr. Jeffrey R. Weiss, MD, Professor and Chair at the Department of Urology SUNY Downstate College of Medicine, Brooklyn, NY, one of the key reasons for nocturia is that the kidney produces more urine at night as people grow older.  This is caused by decreased levels of Anti-Diuretic Hormone -ADH.  

ADH is a powerful hormone that regulates water metabolism in the body. It has direct impact on the amount of the urine the kidney produces. The lower the ADH levels, the more urine will be produced.

In people 60 and older, the nighttime ADH level becomes barely detectable. For them, the urine volume produced at night (average 8 hours) is about 34% of the total volume for the entire day. The more urine produced, the more often you need to void.

As a comparison, younger people’s ADH level increases at night. The urine volume produced at nighttime in people younger than 25 years old is only about 14% of the total volume for the entire day.  This means for young people, urine production is drastically reduced at night.  That’s why their bladders can easily hold urine for the whole night.

Nocturia and ADH

So the older one gets, the less the ADH, the more urine production at night and so the nocturia.

To your health,

Peipei Wishnow, PhD.