Nocturia, pollakiuria and dysuria

The definition of nocturia refers to a disorder in which a frequently nocturnal stimulus to micturition occurs, that is, that a person with nocturia wakes up several times a night to urinate.

This means an interruption of sleep, which can lead to fatigue and sleepiness during the day.

Nocturia is most common in the elderly and menopausal women, but can also occur in young people.

It affects both men and women.

Under normal circumstances, the urine is much more concentrated and the individual can sleep for 6-7 hours without having to go to the toilet.

However, in people who suffer from this problem, the bladder becomes overflowing and signals to the brain that you need to wake up.

There are several possibilities:

  • The capacity of the bladder is reduced (for example, due to the pressure of prostate enlargement or a tumor),
  • The brain receives the signal to urinate, even if the bladder is not full,
  • There is excessive urine production.


What are the causes of nocturia?

There are many possible causes of nocturia, some occur spontaneously and are temporary, others are permanent:

  • Drink a lot, in this case the amount of urine produced is plentiful.
  • Fear, an anxious person often feels the stimulus to urinate, even if the bladder is not filled.
  • Untreated diabetes (type 1 and type 2) – High blood sugar increases thirst, so the person in question drinks a lot and urinates a lot.
  • Diabetes insipidus, the body produces the hormone ADH (vasopressin), as a result of which the kidneys produce unconcentrated urine. The result is large, diluted amounts of urine.
  • Gestational diabetes (it occurs only during pregnancy).
  • Decompensated heart failure – During the day, the body accumulates fluids and mineral salts. At night, vasoconstriction is reduced and the lying position allows venous return. This causes fluid excretion through the urine.
  • Lower limb edema (swollen legs) – During the day, gravity makes it difficult for fluids to flow back to the heart and accumulate in the lower extremities. At night, gravity does not apply, and fluids can flow more easily to the heart and kidneys.
  • Sleep disorders such as obstructive sleep apnea (during sleep, breathing stops several times).
  • Some medications, including diuretics, cardiac glycosides, demeclocycline, lithium, methoxyflurane, phenytoin (used to inhibit hormone release ADH), and too much vitamin D.
  • Drinking too abundantly before bedtime, especially coffee, caffeinated beverages or alcohol.
  • Recurrent urinary tract infections, they are a typical female disorder.
  • Inflammation of the bladder (cystitis).
  • Interstitial cystitis (causes bladder pain).
  • Malignant tumor of the bladder – Can exert massive pressure on the bladder, which causes urination.
  • Hyperparathyroidism – Due to the increase in serum calcium.
  • Irritable bowel syndrome – Can be the result of overactivity of the smooth muscles of the whole body, including the bladder.
  • Glomerulonephritis – inflammation of the renal corpuscles, also characterized by dark colored urine,
  • pyelonephritis – inflammation of the renal pelvis and renal parenchyma, also causes fever and back pain,
  • renal insufficiency – the kidney does not work properly, initially the patient suffers from nocturia,
  • Benign prostatic hypertrophy (a male disorder), non-cancerous tissue growth on the prostate that hinders the flow of urine.

Possible causes of mixed nocturia

Possible causes include nocturnal polyuria and low bladder capacity during the night.

Risk factors of nocturia

In most cases, this disorder occurs only occasionally and then when drinking too much before bedtime.

In some cases, it is observed that diuretic and prescribed medications for bipolar disorder can cause this condition.

Frequent urination during the night is one of the most common symptoms that occurs during pregnancy. However, it passes again after childbirth.


Dysuria is a painful or arduous micturition and is accompanied by stinging and burning.

Some disorders cause pain in the bladder or perineum.

In women, the disorder is very common, but it also exists in men and at any age.

The most common causes of painful urination:

Infections. Urinary tract infections are one of the main causes of painful urination. Infections can occur in almost all areas of the urinary tract:

  • Nephritic
  • Ureters (tubes that carry urine from the kidneys to the bladder)
  • Bladder
  • Urethra (tube that originates from the bladder and directs urine out of the body)

Urinary tract infections are often caused by bacteria that travel to the urinary tract through the urethra.

Factors leading to possible urinary tract infections include:

  • Female
  • Diabetes
  • Advanced age
  • Prostate
  • Kidney stones
  • Pregnancy
  • Wearing a bladder catheter

What is a pollakiuria

Pollakiuria is increased urination, even if the amount of urine excreted is constant.

Those who suffer from this disease must urinate more often, even during the night, and they therefore also suffer from nocturia.

Causes of pollakiuria

  • Infection of the bladder
  • Bladder tumor – The tumor mass presses against the bladder wall and reduces the space for the amount of urine, resulting in increased urination.
  • Overactivity of bladder muscles
  • Nerve disorders that control the bladder muscles, for example, multiple sclerosis or stroke.
  • Diabetes
  • Hyperparathyroidism
  • Menopause – Due to the reduction of estrogens.
  • Obesity and pregnancy – The weight of the stomach and uterus causes pressure on the bladder
  • Irritable bowel syndrome
  • Renal insufficiency – initially causing large amounts of unconcentrated urine
  • Kidney infection
  • Prostate tumor
  • Prostate enlargement – Causes pressure on the bladder, leaving less room for urine. A small amount of urine leads to bladder filling.
  • Urinary incontinence.

Symptoms that occur with nocturia

A person suffering from nocturia feels a need for micturition more than two or three times during the night.

One should not confuse this disease with enuresis, where children involuntarily wet in their sleep.

The flow of urine may be interrupted or decreased.

In case of interrupted urine flow, it is necessary to squeeze to excrete the urine.

Due to the frequent urination, the urine could often only drip instead of flowing normally.

This is one of the most common symptoms of nocturia.

Along with nocturia, other symptoms may occur, such as:

  • Sudden urge to urinate
  • Reduction of micturition frequency during the day
  • Accidental loss of urine during the night
  • Change in urine concentration
  • Difficulty urinating
  • Burning sensation during urination (with cystitis)
  • Lack of sleep and irritation

How to treat pollakiuria?

Treatment depends on the cause of the disorder.

The doctor may prescribe a medication (for example, antibiotics) or a change in diet (for diabetes).

Natural remedies: herbs for nocturia

Serenoa repens

Serenoa repens (also known as saw palmetto) is a plant that may be helpful in treating nocturia.

Serenoa repens is a dwarf palm whose fruits have been used for centuries by the Seminole tribe in Florida for medicinal purposes. It has a sweet taste and an absorbent effect.

The ripe fruit inside the plant is used to cure many health problems, especially problems of the genitourinary tract.

Serenoa repens is a diuretic and antispasmodic agent that promotes the metabolism of urinary tract tissues.

Serenoa repens is used to treat atony (or lack of muscle tone) of the pelvic organs, including the bladder.

Pumpkin seeds

This is arguably the most effective natural remedy for avoiding the nightly awakening to urinate.

It is recommended to eat pumpkin seeds in the evening after dinner.

There is no ideal amount for everyone, usually one tablespoon per day is enough.

Pumpkin seeds contain amino acids, vitamins, mineral salts and other herbal ingredients that help reduce prostatic hypertrophy (enlarged prostate) and improve urinary tract health:

  • Magnesium, zinc and iron
  • Tryptophan:
  • Fatty acid omega 3
  • Vitamins: A, B1, B2 and B3
  • Sterols
  • Cucurbitin.

Asian pennywort

Centella asiatica is a plant that can be useful for fighting nocturia.

It is a perennial, herbaceous plant native to:

  • India
  • China
  • Indonesia
  • Australia
  • Madagascar.

Centella is a slender climbing plant that has a sharp taste and cooling effect.

The whole plant is used for medicinal purposes.

It serves to improve the vascularization of connective tissue, including the tissue lining the inner bladder wall.

Centella is useful for:

  • The treatment of incontinence,
  • The stimulation of the natural growth of the supporting tissue of the bladder.

Increasing bladder tone contributes to the reduction of nocturia.

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