Men's Health

For men urinating too much: causes and treatments


March 6, 2017

Benign prostate issues might be to blame.


If you’re a man who has to urinate too much and you’re frequently up in the middle of the night, or if you have trouble starting to go or have a weak flow, you might be wondering what causes frequent urination. The culprit could be a benign prostate issue.

We asked Douglas Milam, M.D., associate professor of urologic surgery at Vanderbilt University Medical Center, what prostate issues might cause you trouble and what you can do about them.

“Prostate cancer is a silent disease,” Milam said. “The symptoms men may be having are rarely associated with cancer.” However, urinary frequency or trouble with urination can be quite frustrating, and anyone who is experiencing these symptoms should talk to his doctor. (Men should also talk to their doctor about when to begin prostate cancer screening.)


Benign Prostatic Hyperplasia

Most men will get Benign Prostatic Hyperplasia, an enlarged prostate, as they get older. Symptoms usually start at 50 years of age, according to the U.S. National Library of Medicine. These may include the urge to urinate frequently, trouble initiating urination, a slow or weak stream, feeling as if you have to go again after just urinating, or seeing small amounts of blood in the urine. Benign Prostatic Hyperplasia does not increase your chance of getting cancer; however, severe cases can cause serious problems like urinary tract infections or bladder and kidney damage.

“The main issue is decreased force of strain,” Milam said. “Some men in their 50s don’t urinate as fast as they used to, but still don’t have any trouble.”

Only about 1 or 2 percent of men end up developing urinary retention and need a catheter and require surgery, he adds. This can happen when a man is in his 50s, but most patients at this stage are in their 60s and 70s.

Fortunately, there are treatments that can offer relief. Your doctor might prescribe an alpha blocker, which relaxes the smooth muscle at the junction of the bladder and the prostate. “Alpha blockers produce a noticeable effect within a few doses,” Milam said.

Another option is a 5-alpha-reductase inhibitor, which is used to shrink the prostate over the course of several months. “That, of course, is a slow process,” Milam said. “So if a patient starts a 5-alpha treatment, then they should commit to at least six months of therapy before they make a determination if it is helping or not.” Some men may require a prostate resection surgery.



Prostatitis (inflammation of the prostate) is another benign issue that may cause discomfort. A man with prostatitis may experience burning or pain with urination or urinary frequency, Milam said. While the cause of prostatitis is unclear, there are two subtypes: bacterial and nonbacterial. Most people with inflammation of the prostate have nonbacterial prostatitis. “Many would argue it is a pelvic-floor dysfunction or pelvic-pain syndrome,” Milam said.

If you are experiencing these symptoms, talk to your doctor about treatments. Some options may include nonsteroidal anti-inflammatory drugs, alpha blockers or alternative-medicine therapies.




Vanderbilt Urology Clinic offers the latest, most comprehensive care for a wide range of urologic diseases and conditions, including cancers of the prostate, bladder and kidneys and other urologic cancers; incontinence and other bladder-control problems; kidney stones; and sexual health problems, including erectile dysfunction (impotence). Details: 615-322-2880.