Expert: Dr. Kristina Conner - 10/6/2010

Question
Hi Dr. Conner,

I am looking for advice or a second opinion on a problem I have been having.

I am a 65 year old man, retired, living alone.

In May of this year I started having to urinate at night almost every hour. I have a good stream and no pain, no blood in the urine. No day time problem.

Tests showed a urinary tract infection which was quickly cured with ciprofloxacin. My Doctor suggested it was probably a prostate problem. A series of xrays showed my bladder filling up with water and then subsequent exposures at 15 minutes, emptying. The lab said my bladder was not emptying completely leading to the infections. They suggested I had an enlarged prostate. Tests gave my PSA 1.35. Further tests confirmed my prostate was not the problem and that I had a high urea acid content in my blood. I only drink socially, perhaps 2 glasses of wine/week, have drunk only soy milk for several years.

I have been taking a presciption for alopurinol for one month.

Urine and blood tests yesterday showed no infection and urea acid back to normal levels. I have a follow up appointment with a urologist in early December.

Does this sound like a reasonable diagnosis to you? Lately I have been still getting up 3-4 times a night to urinate. Is it just old age creeping up.

Thanks for any advice.  

Answer
Hello Ron,
I can't offer a complete second opinion without knowing your full history, but it this sounds like a fairly standard treatment using conventional medicine.  Both enlarged prostate and high uric acid/ gout are common in men of your age, and there is evidence from the lab tests that support a high uric acid.  However, it could be a combination of several factors and that is what is detectible.  If it is happening only at night, you may want to alter some of your habits and see if that makes a difference.  For instance, many people will stop drinking any fluids earlier, or vary what typical foods they eat for dinner (especially citrus, tomatoes, spicy foods, alcohol can be more irritating to the bladder).  Sometimes the addition of soothing teas later in the day (slippery elm, marshmallow, chamomile) or juices like aloe may help decrease irritation.  But if some minor changes do not make a big difference, it is a good idea to seek out further advice in person, because perhaps there is something else.  We do expect some normal changes with age, but it sounds like it happened rather suddenly, which could be a sign there is another condition to investigate.  
In health,
Dr Conner