Dr. Weinberg dedicates this page to visitor questions.  Please email questions you may have or topics you would like more information on and Dr. Weinberg will post his answers and thoughts on this page.  Please send your questions to jweinbergmd@gmail.com.  All personal details will be excluded for your anonymity.  Check back often for new questions and answers!


Question Topic: Nocturia – Is it Normal?
Date:  February 13, 2013
Author: Dr. Weinberg

Nocturia is defined as the need to get up during sleep with the urge to go to the bathroom. Is Nocturia normal? Unfortunately, this is not an easy question to answer since the causes may be multifactorial.

When wondering if it’s normal, think about your nighttime voiding pattern and if it has changed. If you have woken up to go to the bathroom for many years then this is likely your habit/sleep pattern; and it usually does not represent an underlying problem.

For those who typically sleep through the night, waking up can be disturbing and perhaps the sign of a problem. In general, as people get older their sleeping patterns change.  With a change in one’s sleeping pattern, it is not unusual to wake up in the middle of the night and feel the urge to use the bathroom. However, if this occurs often and more than what you’re accustomed to, it may be an issue.

Questions to ask yourself:

Am I drinking too much liquid before bedtime? 
The bladder has a limited capacity and if you drink a lot before bedtime your bladder will fill up while you sleep. When your bladder reaches capacity your brain signals that you need to go which wakes you up and gives you a feeling of urgency.

Am I taking medication before bedtime?
Certain medications, taken before bedtime, can make you wake up to urinate. If you have started any new medications it may be worthwhile to consult your physician as to their side effects.

Separately, there are several other factors that can lead to Nocturia:

Overactive Bladder: An overactive bladder means that the nerves in the bladder are very sensitive and they trigger the brain to wake you up with the urge to void sooner and more frequently than normal.

Enlarging Prostate: Men with an enlarging prostate can wake up in the middle of the night. This happens as big prostates can put pressure on the bladder and trigger an urge to urinate.

It is difficult to say if Nocturia is “normal” for each individual circumstance. If you are getting up more frequently than you’re used to; it would be a good idea to consult a Urologist and seek medical advice.  If you would like more specific or detailed information, please email Dr. Weinberg directly: jweinbergmd@gmail.com


Question Topic: Over the counter medication (Oxytrol) for overactive bladder in Women – OK to try?
Date:  January 31, 2013
Author: Dr. Weinberg

The FDA recently approved an OTC remedy (Oxytrol) for over active bladder in women.  The full article can be read on webmd.
Dr. Weinberg was asked for his opinion on the availability of the drug; response below:

Women have suffered in silence for far too long. Being unable to control one’s urination has resulted in wetness and/or wearing pads.  Some women are embarrassed to seek treatment and reluctant to join in socially due to their fear that the odor may be too disturbing/noticeable to others.  Without a solution, an overactive bladder has often resulted in a life of loneliness and discomfort.

For quite some time, Urologists have known that there are options to help urinary incontinence, but the patient needed to first schedule an appointment. Now, there is an over the counter medication that helps a woman take the first step while maintaining her privacy.  For some women it will make the difference between living with their problem and overcoming their problem.

I encourage all women who believe this medication may help them to try it (assuming they have no contraindications) and to seek help from their Urologist if needed.

If you would like more specific or detailed information, please email Dr. Weinberg directly: jweinbergmd@gmail.com


Question Topic: Kidney Stones
Date:  January 17, 2013
Author: Dr. Weinberg

The pain associated with having an obstructing kidney stone has often been recalled as the worst pain anyone can ever have. This common understanding leads individuals to try to avoid developing a kidney stone at all costs.

How Quickly do Kidney Stones Form?
Kidney stones take several months to form; once formed, they can increase in size and possibly dislodge from the kidney and enter the ureter, the funnel shaped tube that connects the kidney to the bladder.
How Does the Kidney Function
The kidney acts as one of the filtration systems for the human body. Blood rushes through the kidney and the kidney excretes the excess fluid combined with certain metabolites, which forms your urine. The urine travels down the ureter into the bladder, a reservoir that stores the urine from both kidneys until it is excreted out the urethra.
How Does a Kidney Stone Form?

The metabolites that filter through the kidney can crystallize. These crystals have a tendency to bind to each other and, when enough crystals bind to each other, a stone is formed.
Why do People Form Kidney Stones?

There are many reasons why individuals form stones including but not limited to: genetics, gastrointestinal tract disorders and kidney disorders.  Genetics can play a role in the tendency to form stones, namely, if one of your parents have a tendency to form stones then you may have inherited that tendency. It could be a disorder in the way your gastrointestinal tract absorbs certain metabolites leading to an excess of metabolites filtering through the kidney or it can also be a disorder in your kidney that is improperly filtering these metabolites. These are just some of the reasons, but once a stone is formed it is difficult to dissolve. If a stone falls into the ureter or gets too large, it can harm kidney function and possibly lead to infection.
Can You Prevent Kidney Stones?

For those people who are prone to forming kidney stones the universal treatment is to drink a lot of fluids. Drinking plenty of fluids will reduce the risk of crystals forming and help prevent them from binding to each other. For some kidney stone formers, dietary restrictions or medication may be necessary.  Many people take nutritional supplements or maintain diets that are rich in calcium and other substances that can increase the risk of stone formation and must exercise caution in their effort to eating healthy.
For those patients who exercise regularly, sweat, or do physical work that results in the loss of water, maintaining a high fluid intake is necessary. Water is best, but for those who prefer flavored drinks, the main theme is to remain well hydrated.

If you would like more specific or detailed information, please email Dr. Weinberg directly: jweinbergmd@gmail.com