Frequent urination: Causes, symptoms, diagnosis, and treatment tips

By: Devon Andre | Bladder | Sunday, August 13, 2017 - 05:30 AM

If you have the need to urinate more than you normally would, you suffer from frequent urination or polyuria. While in some situations it can be a temporary issue, it could also be a symptom of an underlying medical condition that requires careful attention.

Doctors consider urinating every two hours or more frequent urination. The key to dealing with this problem is figuring out the cause and getting the right treatment. Frequent urination can be a challenge, since in some cases, a person may lose control of their bladder when the urge to go to the washroom strikes. It can be uncomfortable since your bladder can feel very full.

Polyuria is not just an inconvenience. It can affect the quality of your sleep since you’re waking up at the night to go to the washroom. It can also be a symptom of a medical condition. Research suggests that many people with this problem avoid discussing it with a doctor because they find it too embarrassing, while others are too afraid to bring it up because they fear the underlying cause may be serious.

The truth is, when people seek medical attention for frequent urination, they often discover that the cause is not serious and can be easily treated. In fact, for some people, the reason for the urge to urinate is as simple as drinking too many fluids. Pregnant women urinate a lot because the enlarged uterus is pressing on the bladder, so pregnancy could be the issue for some people.

Since some frequent urination causes can be more serious, it is best to get an assessment from a doctor.

Causes of frequent urination

There are a number of frequent urination causes that doctors consider when a person complains about the sudden urge to urinate or the need to urinate frequently. One cause that sounds almost too simple is anxiety

Stress and anxiety can trigger stress hormones to travel to certain spots in the body – the bladder is one of those areas – and bring about physiological changes. Relaxation and stress reduction often eliminate frequent urination.

Below is a list of other potential causes of frequent urination:

  • Urinary tract infection – An infection in any part of your urinary. Most infections are in the bladder and the urethra.
  • Medications – Certain drugs, including diuretics, can lead to increased urination
  • Enlarged prostate – This can lead to frequent urination in men.
  • Infection of the prostate gland – A bacterial infection that causes frequent urination.
  • Kidney infection – Can involve symptoms like cloudy and smelly urine along with urination frequency.
  • Overactive bladder – This is a sudden urge to urinate that you can’t control due to unexplained, uncontrolled bladder contractions.
  • Tumor or mass in the pelvic area
  • Interstitial cystitis – This is inflammation of the bladder wall.
  • Bladder cancer
  • Bladder dysfunction
  • Abnormal opening in urinary tract
  • Urinary incontinence
  • Diverticulitis – This is inflammation of the inner lining of the large intestine.
  • Diabetes – Can happen when the body tries to rid itself of unused glucose through the urine.
  • Diabetes insipidus – An uncommon disorder leading to an intense thirst and excretion of large amounts of water.
  • Artificial sweeteners – Known for irritating the bladder, causing frequent urination
  • Alcohol and caffeine – Can act as a diuretic, leading to increased urination.
  • Cystocele – Weakening of the supporting tissue between a woman’s bladder and vaginal wall
  • Kidney stones
  • Vaginitis

 

Some causes and features of excessive urination
Cause Common features Tests
Cystitis (bladder infection) Usually in women and girls

A frequent and urgent need to urinate

Burning or pain during urination

Sometimes fever and pain in the lower back or side

Sometimes blood in the urine or foul-smelling urine

Urinalysis and urine culture
Pregnancy Typically during the last several months of pregnancy A doctor’s examination

Sometimes urinalysis (to look for a urinary tract infection)

Prostate enlargement (benign or cancerous) Mainly in men over 50

Slowly worsening urinary symptoms, such as difficulty starting urination, a weak urine stream, dribbling at the end of urination, and a sensation of incomplete urination

Often detected during a digital rectal examination

Blood tests to measure the PSA level
If the PSA level is elevated, biopsy of the prostate
Sometimes ultrasonography
A tender prostate detected during a digital rectal examination

Often fever, difficulty starting urination, and burning or pain during urination

Sometimes blood in the urine

In some cases, symptoms of a long-standing blockage in the urinary tract (including a weak urine stream, difficulty passing urine, or dribbling at the end of urination)

Urinalysis and urine culture and a digital rectal examination

Radiation cystitis (bladder damage caused by radiation therapy)> In people who have had radiation therapy of the lower abdomen, prostate, or perineum (the area between the genitals and anus) for treatment of cancer A doctor’s examination

Sometimes insertion of a flexible viewing tube into the bladder (cystoscopy) and biopsy

Spinal cord dysfunction or injury Weakness and numbness in the legs

Retention of urine or uncontrollable loss of urine or stool (urinary or fecal incontinence)

Sometimes an obvious injury

MRI of the spine
Stones in the urinary tract (that do not block the flow of urine) Occasional episodes of squeezing pain in the lower back, side (flank), or groin that comes and goes

Depending on where the stone is, possibly frequent urination or sudden, severe urges to urinate

Urinalysis

Ultrasonography or CT of the kidneys, ureters, and bladder

Substances that increase the excretion of urine, such as caffeine and alcohol Occasional episodes of squeezing pain in the lower back, side (flank), or groin that comes and goes

Depending on where the stone is, possibly frequent urination or sudden, severe urges to urinate

 

Urinalysis

Ultrasonography or CT of the kidneys, ureters, and bladder

 

Urinary incontinence Unintentional passage of urine, most often when bending, coughing, sneezing, or lifting (called stress incontinence) After water is inserted into the bladder, measurement of changes in pressure and the amount of urine in the bladder (cystometry)
Disorders that primarily increase the volume of urine
Diabetes mellitus if uncontrolled Excessive thirstOften in young childrenSometimes in obese adults, who may already be known to have type 2 diabetes Measurement of blood sugar (glucose) level
Diabetes insipidus, central Excessive thirst that may appear suddenly or develop gradually

Sometimes in people who have had a brain injury or brain surgery

 

Blood and urine tests, done before and after people are deprived of water, then given antidiuretic hormone (water deprivation test)

Sometimes blood tests to measure the antidiuretic hormone level

 

Diabetes insipidus, nephrogenic Excessive thirst that develops gradually

In people who have a disorder that may affect the kidneys (such as sickle cell disease, Sjögren syndrome, cancer, hyperparathyroidism, amyloidosis, sarcoidosis, or certain inherited disorders) or who take a drug that may affect the kidneys (usually lithium, cidofovir, foscarnet, or ifosfamide)

 

Blood and urine tests

Sometimes a water deprivation test

 

Diuretic use
In otherwise healthy people who recently started taking a diureticSometimes in people who take a diuretic surreptitiously (for example, competitive athletes or other people trying to lose weight)
Usually only a doctor’s examination

 

Drinking too much fluid (polydipsia) often due to a mental health disorder Sometimes in people known to have a mental health disorder Similar to tests for central diabetes insipidus

 

Symptoms associated with frequent urination

If you experience frequent urination, you might feel the urge to go to the washroom a lot, but that is not the only symptom associated with this condition.

When you see a doctor for urination problems, they will discuss the volume of urine you are getting rid of, whether you are having difficulty emptying your bladder, and if you are having any accidents.

These are all symptoms that could help determine the cause of the frequent urination. Although every person is different, the basic symptoms of frequent urination include the following:

  • Urgency – The uncomfortable feeling in the bladder making you rush to the bathroom.
  • Burning when urinating – Also called dysuria, it is the feeling of pain or burning during or immediately following urination.
  • Dribble when urinating – After finishing urination, drips of urine still continue to dribble out.
  • Unexplained leakage – When you wet your pants without knowing when or how.
  • Bladder pain – Pain felt in the lower abdomen.
  • Urinary incontinence – The inability to control the flow of urine.
  • Leakage when coughing – During fits of laughter or coughing, minute amounts of urine leak out.
  • Blood in urine – Often a sign of kidney problems and can be in small amounts, clots, or very bloody.
  • Hesitancy – The urge to urinate, but nothing comes out.

When urinary frequency is impacting your life in a significant way or you have unexplained symptoms – including pain in your back, a fever, chills, bloody or cloudy urine, or discharge from the vagina or penis – you should seek medical attention. It is also important to see a doctor if you notice a sudden increase in thirst.

Diagnosis of frequent urination

In order to diagnose the cause of frequent urination, a doctor will likely ask a lot of questions and conduct a physical exam. Here are some of the questions you can expect. Do you have problems with urination during the day or at night? Is frequent urination at night leading to a lack of sleep? How much liquid do you drink in a day? Do you drink alcohol or caffeinated beverages? What medications, if any, do you take? Depending on your answers and your medical history, the doctor may conduct one or more of the following:

  • Urinalysis – This is to measure various compounds that pass through the urine.
  • Cystometry – A test that measures the pressure inside the bladder to see how the bladder is working.
  • Ultrasound – Diagnostic imaging to visualize the bladder and surrounding area.
  • Neurological tests – Diagnostic procedures to confirm or rule out a nerve disorder.

While the tests may sound scary, they are actually quite simple and painless. Once the tests, physical exam, and questions are complete, the doctor will be closer to the cause and will be able to put you on a treatment plan of some sort.

Treatment options for frequent urination

When frequent urination turns out to be something other than a temporary issue, such as a urinary tract infection, there is no need to despair and to think that you are destined to be a hermit because you need to be near a washroom at all times. While there is no cure, there are a number of different treatments that can help keep frequent urination episodes under control.

For example, if diabetes is the cause, treatment might involve managing blood sugar levels. If a person has an overactive bladder, treatment could begin with behavioral therapies, such as bladder retraining, diet adjustments, and Kegel exercises. Bladder training slowly increases the intervals between using the washroom to help your bladder retain urine longer. Kegels are exercises to strengthen the muscles around the bladder and urethra to improve bladder control.

Treatment for frequent urination can also involve medications. Some drugs come in the form of tablets, while others come in the form of a patch. In recent years, the drug Botox has been used to treat some people with frequent urination. The serum is injected into the bladder muscle, causing it to relax and increasing its storage capacity. This can reduce episodes of leaking.

Surgery is possible, but it should be a last resort. The least invasive is a procedure that involves implanting a nerve stimulator beneath the skin to help manipulate contractions in the muscles and organs within the pelvic floor.

In many cases, people find that simply monitoring their fluid intake is really helpful. For example, they notice if they avoid drinking close to their bedtime they don’t experience as much urination. At the same time, avoiding certain foods, such as spicy foods, chocolate, artificial sweeteners, and other foods that can irritate their bladders can reduce urine frequency.

About 13 million Americans suffer from urinary frequency, and it is not just the older population. People of all ages can have urinary problems. Many young patients experience an abnormal opening or obstruction in the urinary tract, which is also called a functional bladder outlet obstruction. It can be treated. On the other end of the spectrum, the elderly experience a lot of incontinence – about 77 percent of nursing home residents.

No matter what age or stage of life you are in, you don’t have to live with the discomfort of urinary frequency. As you can tell, it is rather common, so doctors are accustomed to discussing it with patients.

Related: Natural home remedies for frequent urination


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Related Reading:

Common causes of frequent urination at night (nocturia): Symptoms, treatment, and natural remedies

Lower back pain and frequent urination: Causes and treatments

Sources:

http://www.webmd.com/urinary-incontinence-oab/frequent-urination-causes-and-treatments#1
http://www.emedicinehealth.com/frequent_urination/page2_em.htm
http://www.mayoclinic.org/symptoms/frequent-urination/basics/causes/sym-20050712

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