Waking up four times a night (also called nocturia) is certainly very disruptive for anyone, and you should rightly be concerned. The most likely causes are age-related changes in the bladder and prostate enlargement.

Less likely but equally important are urine infection, bladder stones, or any medication he might be taking that leads to increased urine production, for instance some diuretic medication for high blood pressure.

Sometimes, taking drinks like alcohol, tea and coffee at night may aggravate the symptoms of nocturia. Your husband’s problem should be checked early, so do get him to seek medical advice as soon as possible.

As part of the regular health checkups with your primary care physician, questions relating to urinary symptoms will be asked. If there is any concern about enlarged prostate from benign prostatic hyperplasia, or even suspicion of prostate cancer, then the appropriate referral to a urology specialist will be made.

The urologist will decide on all the tests and checkups necessary.

"Based on local studies, roughly 30-40 per cent of Singaporean men above 50 will have lower urinary tract symptoms to varying degrees, with some symptoms attributable to benign prostatic hyperplasia (BPH), a condition which is co-managed by your urologist and primary care physician. The average age group at our clinic for BPH is 60-65 years."

Ref: R14