By Khabar Rojana 
Waking up often at night to urinate isn’t just ageing; it can be a sign of prostate problems. Learn the symptoms, causes and treatment options.
Getting out of bed during the night to urinate is a complaint that almost all men experience at some point in their lives, especially as they age. Most men think of it just as a factor of ageing, but this symptom can often be the earliest sign of changes in the prostate.
According to Dr Nitin Shrivastava, Lead Consultant – Urologist, Manipal Hospital Gurugram, understanding this symptom in the broader context of lower urinary tract dysfunction is key to ensuring timely evaluation and intervention.
Understanding Prostate-Related Urinary Problems
The prostate is a small gland located just below the bladder, mainly surrounding the urethra, the tube that carries urine out from the body. First, even small changes in the prostate can affect the way a man passes urine. Second, the gland will often enlarge with age (benign prostatic hyperplasia (BPH)), which narrows the urethra, causing stream weakness, hesitancy, straining, or night-time getting up (nocturia). Prostate infections, including prostatitis, can cause painful or difficult urination, urgency, or pelvic pain. Less commonly, prostate cancer can cause similar urinary changes, but more often, prostate cancer may develop slowly and without symptoms. Prostate cancer usually shows symptoms only in later stages, with symptoms including blood in the urine or semen and bone pain.
Symptoms to be aware of:
- Trouble starting urination or a weak or split urine stream
- Straining to urinate or dribbling afterwards
- Waking multiple times during the night to urinate
- Painful urination or pelvic pain
- Blood in urine or blood in semen
Treatment for Prostate Health
- Addressing recurrent nocturia typically begins with pragmatic lifestyle modifications such as:
- Reducing evening fluid intake, especially 2–3 hours before bedtime.
- Avoid caffeine and alcohol in the evening, as they can irritate the bladder.
- Practice double voiding, i.e., urinate once, wait a few minutes, then try again before bed.
- Regular physical activity helps improve overall urinary function.
These all can have a positive impact on symptoms. If these measures are not enough, doctors may recommend medications that either relax the prostate and bladder muscles or gradually shrink the prostate to improve urine flow.
When your symptoms are bothersome despite these medicines, your doctor may recommend a minimally invasive intervention. Minimally invasive interventions are done in a clinic and are effective at reducing or eliminating the blockage. In cases of severe prostate enlargement, surgeries such as Transurethral Resection of the Prostate (“TURP”) or Laser Prostatectomy can provide long-lasting relief from the problem. In prostate cancer, a radical prostatectomy (removal of the prostate) may be necessary via open, laparoscopic, or robotic surgery to remove the cancer while aiming to preserve urinary control and sexual function.
Getting up often at night to urinate is more than just annoying – it can be an early sign of an enlarged prostate, infection, or even cancer. A proper check-up can help tell the difference between normal age changes and something that needs treatment. With early care, simple lifestyle changes, medicines, and, if needed, surgery, men can manage their symptoms and improve their daily life.