I have been observing this thread for some time and it has been tough to keep an eye on the ball. The phenomenon that is nocturia has many root causes, if the medical literature is to be considered as reliable. (this is, depressingly, becoming a necessary rider to whichever sources I have read) Urology was never an area in which I have ever had more than a passing knowledge (or interest in) but many things mentioned in this thread have struck chords with me.
The urge to urinate is a neurological response to an imperitive from the bladder, which is made from smooth (involuntary) muscle. In good health, and with all things being equal, it results from the bladder being full and wanting to contract to empty, so the bladder sends a signal to the brain that it needs emptying. You then get the signal (the urge) to go to the bathroom and voiding (micturition or urination) would normally take place. The list of malfunctions that can interrupt and upset this process is long.
You could separate the causative factors into groups that may help with seeing the issues more clearly. If you were just to look at irritants that may stimulate urine production or mimic the urge to urinate, such as... infections, anywhere in or around the urinary tract, including kidneys, bladder, urethra, prostate, vagina, you could have a whole host of factors that are considered to be contributing to dysuria. Infections within the urinary tract are usually identified by some sensation of 'burning', when voiding urine.
Psychological stresses such as anxiety can also adjust the physiological response of the bladder. We most commonly see this as something like pre-interview (or other important event) 'nerves'. Many people in this situation feel the desire to go to the bathroom and it highlights that the higher centres in the brain have taken over what is usually considered to being an autonomic function of the body. That is, that there is no need for your intervention in filling the bladder and the urge to urinate can be suppressed but you will void if you do not supress the urge (higher centre activity) to urinate.
Physical obstructions to the urinary tract can be responsible for the urge to urinate. Constipation can block the urinary tract because of the proximity of the colon to the urinary tract. Stone production within the kidneys or bladder can block the urinary tract. Tumours within this area can block the urinary tract so in men, benign prostatic hyperplasia (a non-malignant overgrowth pf prostatic tissue) is one possible culprit for blocking the urinary tract.
Needless to say that anatomical changes and other age-related changes may also play a part. As one ages, the sensation of a baldder that needs emptying may be a delayed until the bladder is almost full and then the urge to urinate is very strong, and there may not be enough time to find a place to urinate.
This is not intended to be a comprehensive list of causative factors for the urge to void urine. I merely offer it as the briefest of glimpses into the mysterious (and often wet) world of urological medicine. The take home point is that although the causative factor may be the dreaded, while not particularly useful, multi-factorial answer, it is useful to know that the muscles to the outside opening of the bladder (the external sphincter) are striped (striated or voluntary muscle) and this is just the type of muscle that is affected by statins.
Whenever I see the words 'statin' and 'muscle' within the same sentence, I now assume that statins have wrought their particular brand of dark magic and have royally messed with the underlying system. I know that is not particularly scientific but it makes just as much sense as implicating cholesterol in every trouble known to beset the animal kingdom. :roll) It also has the benefit of reminding me that statins are not to be considered to be bio-friendly substances and any opportunity to avoid taking them should, in my opinion, be grasped with alacrity and to heck with the medical profession's naysaying.
My small knowledge about statins, raises my index of suspicion for neural damage. While I was looking for information to assist me to speak coherently about the issue of nocturia, I was reminded of doc's own piece on ALS. You will find it at
http://www.spacedoc.net/ALS_statins.html and after reading some truly distressing stories, it is plainly obvious that the pharmaceutical interference with the mevalonate metabolic pathway (via statins) has produced far-reaching and disasterous consequences. The disturbing propensity for physicians to treat numbers, rather than people, is exemplified by case #10.
Kind regards,
xrn (desperately trying not to muddy the waters)