[33M] Experiencing urinary symptoms, constant thirst, and occasional dizziness upon standing

Patient Description

A 33-year-old male reports long-standing issues with constant thirst, requiring water intake every ten minutes, which has been progressively worsening over ten years. The patient manages this with adequate water and electrolyte intake, and by limiting sugar. Urinary symptoms include a sensation of incomplete bladder emptying and post-void dribbling, which began around the same time as a past intermittent Adderall use, approximately ten years ago. Additionally, the patient experiences intermittent episodes of dizziness, lightheadedness, vision loss, and balance disturbance upon standing, suggestive of orthostatic hypotension. These episodes have been occurring for several years. The patient is currently on Finasteride and reports no known drug allergies or other medications. There is no history of significant weight loss, visual disturbances, blood in urine, or severe pain in the abdomen or back.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Diabetes Insipidus: This is a rare condition that causes an imbalance of fluids in the body. This imbalance leads to intense thirst and frequent urination. The cause of this condition could be an issue with your kidneys or pituitary gland.

    • Treatment typically involves medications that help your body balance its fluids.
  • Diabetes Mellitus: This is a more common condition where your body either doesn't produce enough insulin or can't effectively use the insulin it does produce. This can lead to high blood sugar levels, which can cause symptoms like increased thirst and frequent urination.

    • Treatment typically involves lifestyle changes like diet and exercise, and sometimes medication or insulin therapy.
  • Benign Prostatic Hyperplasia (BPH): This is a common condition in older men where the prostate gland becomes enlarged. This can cause symptoms like difficulty starting urination, weak urine flow, and feeling like your bladder isn't completely empty.

    • Treatment typically involves medication or surgery.
  • Post Micturition Dribble: This is a common condition where a small amount of urine dribbles out a short while after you've finished urinating. It's usually caused by a small amount of urine being trapped in the urethra.

    • Treatment typically involves exercises to strengthen your pelvic floor muscles.
  • Orthostatic Hypotension: This is a form of low blood pressure that happens when you stand up from sitting or lying down. This can cause dizziness and blurry vision.

    • Treatment typically involves lifestyle changes and sometimes medication.

Please note that these are possible explanations and not a definitive diagnosis. It's important to consult with a healthcare professional for an accurate diagnosis and treatment.

What you can do

Here are some steps you can take to manage your symptoms:

  1. Keep a symptom diary: Note down when your symptoms occur, what you're doing at the time, and what you've eaten or drunk. This can help identify any patterns or triggers.

  2. Stay hydrated: Continue to drink plenty of fluids. This can help manage your thirst and ensure your body has enough fluids.

  3. Pelvic floor exercises: These can help strengthen the muscles that control urination and may help with your post-void dribbling.

  4. Stand up slowly: If you're experiencing dizziness and vision loss when standing up, try standing up slowly. This can help your body adjust to the change in position and may reduce your symptoms.

What you should look out for

Here are some signs that you should seek medical attention:

  • If your symptoms worsen or don't improve
  • If you start to lose weight without trying
  • If you start to feel tired all the time
  • If you notice blood in your urine
  • If you start to feel confused or have trouble concentrating

Remember, it's important to consult with a healthcare professional for an accurate diagnosis and treatment.

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1 yr ago

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People Also Ask


What is diabetes insipidus and how does it differ from diabetes mellitus?

Diabetes insipidus is a condition characterized by an imbalance of fluids in the body, leading to intense thirst and frequent urination. It is caused by issues with the kidneys or pituitary gland. In contrast, diabetes mellitus involves high blood sugar levels due to insufficient insulin production or use. Treatment for diabetes insipidus often involves medications to balance fluids, while diabetes mellitus may require lifestyle changes and insulin therapy.


What are the common symptoms and treatments for benign prostatic hyperplasia (BPH)?

Benign prostatic hyperplasia (BPH) is a condition where the prostate gland enlarges, commonly affecting older men. Symptoms include difficulty starting urination, weak urine flow, and a sensation of incomplete bladder emptying. Treatments can include medications to shrink the prostate or relax bladder muscles, and in some cases, surgery.


How can orthostatic hypotension be managed effectively?

Orthostatic hypotension can be managed by making lifestyle changes such as standing up slowly, increasing fluid and salt intake, and wearing compression stockings. In some cases, medications may be prescribed to help maintain blood pressure when changing positions.


What are pelvic floor exercises and how can they help with post-micturition dribble?

Pelvic floor exercises, also known as Kegel exercises, involve repeatedly contracting and relaxing the muscles that form part of the pelvic floor. These exercises can help strengthen the muscles that control urination, potentially reducing symptoms of post-micturition dribble by improving bladder control.


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