The “frequency problem” – having to get up 2 or 3 times during the night to urinate

The frequency problem is one that seniors often experience – it makes it hard to have a good night’s sleep.

Those who are experiencing it need to understand that different urologists provide two amazingly different and quite opposite explanations for it happening, and therefore different recommendations as to how to deal with it.

Explanation 1 is that patients’ bladders have been reduced in size to about 200 mls, and so, when there is 200 mls of urine in them, they are full. This reduction in size has come about because partial blockages in their urinary tracts have meant that their bladders have had to work harder and harder to eject the urine, which have made their bladders more muscular, and therefore smaller, reducing their size from the more normal 400 or more mls.

Explanation 2 is that patient’s bladders, although still more normal in size, have, for whatever reasons, become too weak to empty properly, so that considerable amounts of urine are left in their bladders after they’ve urinated, and so they are full again sooner.

One of our readers claims that explanation 1 was provided to him by Dr Andrew Brooks, Urologist, in August, 2014, and that Brooks went on to recommend that the partial blockages in his urinary tract be removed surgically, claiming that if this was done, his bladder would gradually become more normal in size, perhaps within 3 months, but certainly within 6 months. But our reader claims that, after he’d submitted to the recommended surgery, Brooks wrote to the referring GP as follows – “Unfortunately the frequency and urgency is not resolved. This is due to the altered wall compliance and loss of functional volume that occurs and occasionally does not remit following relief of the outflow obstruction.” In other words, the surgery, (which, incidentally, involved Brooks in receiving a fee of $3,200 for less than an hour’s work,) hadn’t done a scrap of good.

This failure led our reader to see another urologist, Dr Vincent Tse, some 8 months later, who claimed that the tests he’d carried out on the reader had confirmed that his bladder had a size of 400 mls, and that after he’d urinated, it still had 150 mls in it – which, of course, indicated that explanation 2 had almost certainly been the right one all along.

Readers, the moral of the above is this – if you have the frequency problem, have the capacity of your bladder checked and double checked, and if it has a capacity of more like 400 mls, and not about 200 mls as Brooks had claimed, avoid the Andrew Brooks of this world like the plague.

Brooks had his nurse carry out the “urodynamic study,” (for an extra $600,) which had “confirmed” that the capacity of our reader’s bladder was about 200 mls, and, typically, repeated requests to Brooks for a copy of this study, to which he was/is entitled to by law, have, to this day, been ignored. And when the assistance of the NSW Privacy Commissioner was sought, typically, it was a waste of time. When she wrote to Brooks asking why he’d ignored three emails requesting the copies, his reply was that the ordinary email address on his website, (since taken down,) was set up so that emails sent to him by patients were “weeded out” so he didn’t receive them, (this when technology advisers have advised that it’s not possible to set up ordinary email addresses in this way, and that at least one email sent to him – seeking details as to how to pay his $3,200 fee – had been acknowledge and replied to,) to which the completely and utterly useless Privacy Commissioner had responded with a response along the lines of, “Oh yes, Dr Brooks! that’s a perfectly acceptable explanation as to why you didn’t respond to your patient’s emails.” Eventually Brooks did provide copies of 2 or 3 documents to which our reader was entitled to by law, but NEVER a copy of the “urodynamic study” which our reader was seeking.

The suspicion is obviously raised, that if our reader had sought independent advice as to his bladder’s capacity, as we’re recommending, before he went ahead with Brooks’ surgery, that the claim that it was only about 200 mls was absolute rubbish, and that therefore Brooks’ surgery was NEVER going to work.

But, in an irony that’s quite incredible, if, as Dr Tse has claimed, that 8 months after Brooks had carried his surgery, the capacity of our reader’s bladder was about 400 mls, then everything that Brooks had promised would happen had happened – his bladder’s capacity had gone from about 200 mls to 400 mls, but, he still had the frequency problem! Work that one out, if you can, readers!

It all raises that probability that the capacity of our reader’s bladder was about 400 mls all along, and that explanation 2 is the more likely, about which, according to Dr Tse nothing can be done – no big fat fees for Urologists.

But there’s a postscript to all this. The same reader is claiming that, since he’s been on Low Dose Naltrexone, he never has to get up more than once during the night to urinate, and often doesn’t have to get up at all!!! Although he’s in his 80s, he says it’s as though he’s in his 30s and 40s again. This information has been passed on to various Urologists, in case this information might be helpful to them and their patients, but none of them seem interested.

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