Minimal voids day time, large voids early hours

Kidney and urinary tract
1

Hi there, I have been at this site before several times about this subject. And still things are no better although they do sometimes improve for a short time.

Anyway to cut a long story short, I usually drink about 1500ml each day. So far at 4.30pm, I'm up to 1 litre. 1250 ml with a drink at dinner time and 1500ml by the time I've had a drink in the evening.

My urination is minimal during the day with much bigger voids in the early hours.

Take today for example. 3.10am I had a 600ml void then a 400ml void at 9am. But since 9am I've hardly peed at all. 100ml at 1pm and 50ml at 4.15pm!

I've seen a Urologist, The Doctor and also the bladder nurse about 3 times and they all say that following various scans, flow and volume tests everything is normal.

Now this all started A) When I had an accident at home because I'd just had an hip replacement and couldn't get to the bathroom on time. From the day onwards (May 2nd) my urination changed so that my daytime urination was minimal.

And B) it was made even worse when I had a terrifying urgency episode in town that was extremely painful and overwhelming. It was one of the most scary moments ever. Didn't wet myself, it was a miracle. Think it impacted on me subconsciously though and together with the impact of the accident at home, something has interupted, stopped, slowed down my urination so I avoid another accident or urgency episode.

I notice I get decent voids after I've been relaxed and asleep in bed for a while. But I think that's the problem, I'm so tense and anxious about it during the day that possibly I am involuntarily tightening up my sphincter and reducing my flow.

Scared of: A) Damaging my bladder with too much urine because of low voids. B) Scared of "Excess" urine triggering another urgency episode the same as happened in town that day.

C) Scared of urination stopping completely when I have minimal voids, like now. Going on for 5pm and only voided 150ml so far!

I will add that whilst I am worried about all this, I am not in pain anywhere, no sickness or anything, don't feel ill. No swelling, nothing like that.

All I want is my normal urination back. Anyone else having a similar experience?

2

Do you think your body (kidneys) are not producing sufficient urine or do you feel like you have urine in your bladder but you can't void it all out? Because there is a big difference. If you are producing a normal amount of urine but unable to fully empty your bladder, that's urinary retention. The dr or nurse would easily be able to diagnose urinary retention in their office. They would ask you to void and then post void they do an ultrasound scan of your bladder to measure how many ml are left inside after voiding. Anything above 100ml would usually be considered urinary retention. If that's what your issue is, you would probably feel a constant urge to pee since your bladder never truly empties. Now, if the problem is that your kidneys aren't sufficiently producing urine, that's called oliguria and can be due to dehydration, side effects of medication or some obstruction. It would be important to get to the root cause of low urine output. However, you sound like you do have normal (and actually on the larger side) voids several times a day so I'm not sure if oliguria is your problem. How many different urologists have you seen? I would seek a second opinion if I were you if you feel your current doctor is not listening or taking your concerns seriously.

3

Hi Middlechild, Thanks for your message. I will reply properly tomorrow. I just spent a while replying to you, only to accidentally lose the message! Not done that for ages! So I will start again tomorrow. Thanks again. Shirley

4

How old are you? What and when was your last PSA test? Have you had a DREYou do not sound that bad to me. But I know you are scared of possibly having a problem So trust me that best thing in my opion would be to just get a good MRI and someone to read it. Have you had a Cystoscope?

With the Pelvic Coil 3TMRI, you can detirmine if you have any visual PCa lesions that need a focal single needle biopsy.  And, you will find out the size of the prostate if you have a recent PSA number you can also calculate your density. You are smart to look in to this and get some numbers to detirmine what you are dealing with. 

First look into and find out what you have. Then there are many procedures for BPH. You just have to research them all an elliminate what you do not want.

You also need to learn about Kegel exercises.  And, take you a two to three day urination log. Track time of day and night that you go. Get a Urin Bottle and catch each unination for the acual unirne volume. Log it. Track what, how much and time your intake of liquids. BUT MOST IMPORTANT. Let go and live normal. Don't think about it. Just let it happen. 

I have recently gone through a great procedure but I obsessed like you and I was short cycling myself with going as soon as I had an urge and I would go every 2 hours and that didnt give me a habitual low amount which I also obsessed about. You have to first realize that it is what it is and the best you can do is get a Uro to help you with his appropriate part of the diagnosis and you will need an Intervential Radiologist if this is anything. Let me know what you find out 

Good luck/.

Good luck. 

5

Hi Middlechild, will try again. Re my kidneys producing sufficient urine, I had a 500ml void at approx 5.30am this morning and a 300ml void at 8.45am. I do get good voids in the early hours so my kidneys must be producing sufficient urine but I notice that it's after I have been completely relaxed and all the tension and anxiety gone whilst I've been asleep. I also notice that having relaxed on the sofa for.a while last night, I managed a 300ml void before bedtime. Yet during the day it took all day to void 200ml. Re not being able to get all of the urine out of my bladder, I worry about this when I only do small voids, for example when I've drank a litre and only voided 150ml. But I don't feel like my bladder is still full. And when I press on my self where my bladder is, I don't feel anything. And there is no constant urge to pee either so it begs the question. 1 litre intake, 150ml output. Where is the 850ml? But then I will have decent voids in the morning so that must account for it. I have had several bladder/Kidney scans. All ok. My bladder is emptying I am told. But they are scanning my bladder mostly with 1.5 pints in it so that would give me a good flow and void. They are not scanning my bladder under normal day to day conditions. Having said that, the bladder nurse did last week. I only managed a small void at 9.30am but she scanned my bladder straight after and it was virtually empty. Ideally I would have had a 4om appointment, drank 1 litre and had a small void then it would have been interesting to have her scan me then. Only seen one Urologist. Got to see him again on Feb 15th. One thing is for sure, I am voiding. Just not much during the day time. I think part of it is my anxiety. I am wondering if that is somehow slowing down urine production and it steps up once I'm relaxed? I will see Urologist next month and put all this to him but if I get nowhere I will seek a second opinion. Thanks again.

6

Hi J, I am 59 and yes, I'm scared. Sorry no idea what a PSA test is, or a DREY or the other things you mentioned. Also it is highly unlikely I would be given an MRI since I've been told my bladder etc are all fine. No not had a cystoscope either. As for kegel exercises, I was doing them months ago but realised that I can go all day without wanting to wee and even with a 500ml void in the early hours, I'm not bursting so my pelvic floor muscles must be good. Wish I could just get past this obsession and anxiety. It all started following a near accident in town 6 months ago that scared the hell out of me. So I'm seriously wondering if I am somehow involuntarily stopping my flow during the day to avoid the possibility of another accident. Then things return to normal when I'm relaxed and not thinking about it. Will get back to you when I've see Urologist on Feb 15th. Thanks again.

7

Another thing springs to mind whilst I'm sitting here. I have been known to void as much as 700ml in one go in the early morning. The bladder nurse said it means I've got a good bladder capacity. I'm wondering if this is why I'm not voiding much all day and I find I only need to go when I can do decent voids, like 300ml last night after I had been relaxed for a while and the voids this morning too. Makes me wonder if there is a link between my infrequent urination and low voids and my large bladder capacity.

8

The PSA test is for men only and relates to the prostate.

9

Oh right I see now. Doesn't apply to me then.

10

Well you have to get that stuff out of your head. Stop caring so much for a few days. relax and just live your life. keep the log after you stop doing this for a few days call this of off period time part of your research.

I really do not think you have anything worng but I if you need orders for an MRI given and dont think you can get them, let me know and I have a doctor who will discuss with you and send in an imaging order. He will read it for you at no charge and tell you what he sees. He is wondreful and is helping several men on this site. The two tests you need now are PSA blood test and a 3 TMRI using a pelvic coil. Not rectual coil and totally non invasive procedrue. Pelvic is much more comfortable. With these two test you will know a lot. Prostate size, PSA reading, Density of the tissue, any Stricture of he Urethra, Bladder neck condition, Possible Tribeculation of the bladder wall.  

 

11

I don't understand why you say that Shirley84100 needs to have a "prostate-specific antigen" (PSA) test done as I'm sure she won't have a prostate - or is there another test with the same initials?

12

Well, as the kids say, "MY BAD". I never picked up that Shirley was  a woman!! I have a good freind who's last name is Shirley.

Not really sure how a "womens health" issue thread got through to me when I am signed up for only male issues for the last year?

So with that I have no advice as I am only knowledged in the male plumbing. I know nothing as Sergeant Schultz would say.

But Good luck anyway.

13

Yes you are right J12080, I'm going to have to stop caring so much, relax and just get on with my life aren't I. Sorry, I saw the other post indicating you didn't realise I am a woman. I am thinking this problem of mine is more of an anxiety problem than anything else. Things were fairly ok this morning. My mind was occupied with other things. But this afternoon when I had time to sit and think and worry again, my urination slowed down again. It's now almost 1920pm and I've drank 1250ml up to press. Total in voids is about 300ml. My urologist said I should be voiding 350ml to 450ml at each void. He'll be lucky! He also said I only need to drink 1litre every day so that wouldn't give me many voids would it. I actually drink 1500ml. Daren't drink any more. Bladder Nurse said that was the correct amount, between 1500ml and 2 litres. I think that sounds more like it rather than 1 litre. Am now laying on sofa relaxing hoping for another void before bedtime at 10pm.

14

Golly j12080 that's going back a bit to "Hogan's Heroes" one of the funniest TV shows ever from the 1960s

15

Well, you will pee all night if you drink that much that late. I don't think you have a issue. Just. Live normal and let it go.

16

Sorry, Don't know if I made myself clear. I meant I drink 1500ml all day between approx 8.30am and 7.30pm. My last drink is usually around 7.30pm. Probobly there isn't an issue but it gets scary when I've drank a litre by say 3pm or 4pm and only voided 100ml. But I agree, I am just going to have to somehow let it go.

17

Hi all, I have now seen the Urologist again. Saw him on Wednesday. He said my low voids and infrequency during the day is largely an anxiety problem but the other thing is my age and the resulting changes in my body. Nothing stays the same does it.

I recorded my voids and volumes for three days before I saw the Urologist and he didn't seem concerned.

I had a great day urination wise on Friday, the best in a long time. But I also notice that my mind was off my urination problems and I was more relaxed in my self too.

However, these days are in the minority and yesterday things were back to normal.

And today, well I had a 500ml void at about 9am. Drank about 500ml between 9.15am and 12.30pm then another drink at lunch time so by 1pm I'd drank roughly 750ml. Only managed a mini void.

Had another drink at about 2.30pm then another at 4pm so approx 1250ml up to press (4.15pm) and still only voided once all day since 9am. However if I lay on the sofa for an hour or so, it will probably speed things up a bit. But I shouldn't have to do this. Urologist mentioned that laying down helps the kidneys work better before I even mentioned it.

As a last resort he suggested a Cystoscopy to put my mind at rest as he is convinced nothing is wrong but I asked if he could have missed anything during scanning me. He said he couldn't be 100% but it was unlikely he had missed anything.

He didn't seem concerned but it sure as hell feels strange hardly going to the bathroom all day.

18

I hope you’ve sorted this issue. You really do just need to get over it. You NEARLY had an accident in public, but didn’t. Even if you had, it’s really not life or death. You’ve clearly led a very privileged life if feeling an urge to urinate was “the scariest thing ever”. Of you’re thst worried then we’re a small panty liner designed for bladder leaks, you don’t even need a full pad seeing as though you’ve never had an accident out and about and only once had a leak on you way to the toilet at home.

You’re not going to void the entire volume you intake, that’s not how it works. This is even more so since your intake is so low, you’re probably dehydrated. 1000-1500ml a day is not enough, 1500 is just enough to potentially not get overly dehydrated. The exact intake you need varies according to weight and you’ve not provided those details. Moreover if you’re dehydrated your urine will be more concentrated, if you regularly have concentrated urine this will irritate your bladder over time and cause sudden or frequent bladder contractions at lower volume.

Wear a liner, drink more to ensure you’re properly hydrated, abd grt over yourself, in this case it seems it really is all in your mind.