Alhaji Rasheed had accepted broken sleep as his reward for decades of hard work. Five trips to the bathroom every night for two years. Mascot Healthcare assessed the cause, excluded prostate cancer, and gave him effective medical management.
Retired principal, Ikorodu. Presented with 2 years of progressive lower urinary tract symptoms: nocturia × 5 per night, weak urine stream, hesitancy, incomplete bladder emptying, and daytime frequency. PSA mildly elevated at 4.8 ng/mL; TRUS-guided biopsy negative for malignancy.
Benign Prostatic Hyperplasia (BPH)Alhaji Rasheed is a practical man. When symptoms started two years ago, he applied his usual logic: this is what happens at 58. His wife poured him water before bed for his kidneys. His friends at the mosque told him to take more ginger tea. He managed.
But when the nocturia reached five times per night — and he was sleeping an average of four broken hours — his son (a nurse) insisted he come in. The concern was not just comfort: at five times per night, the son said, someone needed to check the prostate.
At Mascot Healthcare, the doctor ordered a PSA blood test, a full urine test, a prostate examination, and an ultrasound. The PSA was mildly elevated at 4.8 ng/mL — above normal for age, but not dramatically so. The doctor explained this could be BPH or prostate cancer and referred for a urology assessment. A TRUS-guided biopsy was performed — negative for malignancy. The diagnosis: benign prostatic hyperplasia.
Benign prostatic hyperplasia is the most common cause of lower urinary tract symptoms (LUTS) in men over 50. Progressive symptoms — if untreated — can lead to urinary retention and kidney damage.
Waking five times every night to urinate — fragmenting sleep completely for two years.
The stream had become weak, slow-starting, and sometimes dribbling — taking twice as long to urinate as before.
A persistent sensation of incomplete emptying — leading to needing to urinate again within minutes.
Needing to urinate every 45–60 minutes during the day — difficult to sit through meetings.
Sudden, difficult-to-defer urge to urinate — leading to near-incontinence episodes on two occasions.
Restricting evening fluids — provided modest nocturia reduction; not addressing the underlying obstruction.
Ginger tea and herbal supplements — no evidence base for BPH management.
Saw palmetto supplement — limited evidence; insufficient at this severity.
Caffeine reduction — partially helpful as a bladder irritant to avoid.
Uroflowmetry confirmed a reduced peak flow rate (8 mL/sec; normal > 15 mL/sec). Post-void residual urine was 120 mL on ultrasound — elevated. Prostate volume on ultrasound: 56 mL (normal < 30 mL). After negative biopsy, medical treatment for BPH was initiated.
One medication to relax the prostate smooth muscle was started, followed by a second that gradually reduces prostate size over about 6 months. Using the two together is well supported by evidence for moderate-to-severe BPH.
He was advised to avoid antihistamines and decongestants (which worsen urinary retention), continue evening fluid restriction, and return in 3 months for uroflowmetry repeat.
Benign Prostatic Hyperplasia — moderate-to-severe LUTS (IPSS score 22; prostate volume 56 mL; Qmax 8 mL/sec; PSA 4.8 ng/mL — biopsy negative)
Two complementary medications for BPH; lifestyle measures; avoid bladder irritants; repeat uroflowmetry + PSA at 6 months
At 3 months: nocturia reduced from 5 to 2 per night. Urine stream improved. IPSS score improved from 22 to 11. At 6 months: further improvement.
Alhaji Rasheed sleeps in two blocks of 4 hours with one bathroom trip — compared to five per night before treatment. His energy improved markedly with restored sleep.
BPH is not a normal part of ageing to be accepted passively. It is a progressive condition with effective medical treatment — and one that requires cancer exclusion before treatment.
A PSA blood test and prostate examination are simple first steps for any man over 50 with urinary symptoms. Do not wait for acute retention to seek help.
Nocturia more than twice per night in a man over 50 deserves a prostate assessment — not just less water before bed.
Walk in to Mascot Healthcare, Akoka — same-day consultation, transparent pricing, 4.9★ rated.