Originally Posted by: Online Community Member
I have a phone call due this afternoon, from the kidney consultant who arranged for the stent. If I remember to ask, I will ask about the emptying my full bladder first thing, then having the need to go a second time an hour later - as if urine is backing up in my kidneys.
Your hypothalamas monitor's your body's hydration levels. When the interstitial water level between cells starts getting low, it releases antidiuretic hormone. This is picked up by the kidneys, and tells them to recover the water from the urine, so your body doesn't lose so much water, preserving water in the body and making more concentrated urine instead.
During the day, your pituitary also steals some of the antidiuretic hormone, and then releases it overnight. This is intended to slow the rate of water loss into urine overnight, so you don't need to wake up and pee. Excess water is stored elsewhere in the body (blood, which is why blood pressure can raise over night, and as interstitial water between cells). After you wake, your pituitary stops releasing antidiuretic hormone, so this excess water is now excreted by the kidneys.
So your first pee when you wake up is usually quite concentrated, because the overnight antidiuretic hormone told the kidneys to recover the water from the urine, and then after you're awake, you can end up peeing again soon, much more diluted, as your kidneys get rid of that excess water they avoided losing overnight.
So what you describe in the form of peeing twice in quite quick succession when you wake up is quite normal, and shows your antidiuretic hormone mechanism is working well. It is something that deteriorates as we get older, and is one reason you can end up needing to get up to pee at night.
However, that isn't an excuse for any complacency with monitoring for prostate cancer. Your PSA is high, and the slowing of flow first thing could also be caused by growth of the prostate, BPH and/or cancer. It doesn't look to me like you've had an mpMRI scan for prostate cancer, which I would have expected given your symptoms.
Edited by member 30 Jun 2020 at 12:15
| Reason: Not specified