Hope u find a resolution, please pass it on here if u do. Similar stats to urself, no underlying health issues. Bloods always good.
Have had same problem for a long time, came on me in mid-late teens (mid 40s now), long long before i ever touched AS. 4 times a night is a good night for me, 7-8 is average for myself. Sound sleep obviously a problem.
Have been to multiple urologists over the yrs, multiple bloods done, standard flow and urology tests, 2-3 bladder enlarging procedures with minimal success, botox injected into bladder to numb area, which only made problem much worse until it wore off after a few months, combos of every overactive bladder med available, nothing sinister ever detected by any doctor. AS doesn't make it any worse or better for me. On or off, the problem is always the same, have tried every version of myself over the last close to 30yrs since it began. Still have the problem, hasn't worsened in that time but certainly hasn't improved either.
One urologist suggested it might be psychosomatic, others disagreed, to exhaust all avenues, went to mental health specialists, they didn't believe that was the issue. Referred onto a different urologist, different meds, no improvement.
Back to GP, sent back to different urologist again, referred onto a sleep specialist, currently awaiting a call up to a sleep clinic to see if anything shows up. Have been examined for restless leg syndrome before with a stay in hospital, they determined i didn't have it.
Only thing that eases it is an extremely limited fluid intake (read allow myself to get dehydrated), which isn't feasible for someone doing 20-25 hrs in gym each wk between weights and other disciplines. Lifting weights isn't my main physical activity. Have always been that active.
Milk, whey protein, carbonated drinks, caffeine alcohol, fruit juices all massively exasperate it, use vegan protein instead of whey which doesn't aggravate the problem as much as whey. Dairy and sugar free carbonated drinks I find particularly harsh. Pass about 1L per night when in bed.
Lying flat in bed significantly eases it, turning from side to side provokes an urgency to urinate almost immediately. Unfortunately a skill I've never mastered is the ability to fully sleep on my back, as soon as I get into a deeper sleep I twist and turn and the urgency to urinate snaps me back into to waking up.
For myself, surgeries and meds haven't helped, I've just become uncomfortably accustomed to it. But if u find a solution then please share, I really do understand how it can negatively effect quality of life. Who knows, maybe 1 of the 150k odd members here will read this and recognise the problem having experienced it themselves along with having previously found a solution.