Frequent or urgent urination

Definition

Frequent urination means needing to urinate more often than usual. Urgent urination is a sudden, compelling urge to urinate, along with discomfort in your bladder.

A frequent need to urinate at night is called nocturia. Most people can sleep for 6 to 8 hours without having to urinate. Middle aged and older men often wake to urinate once in the early morning hours.

Alternative Names

Urgent urination; Urinary frequency or urgency

Considerations

Common Causes

Together, frequent and urgent urination are classic signs of a urinary tract infection.

Diabetes, pregnancy, and prostate problems are other common causes of these symptoms.

Other causes include:

• Alcohol use
• Anxiety
• Bladder cancer (not a common cause)
• Caffeine
• Enlarged prostate or infection of the prostate
• Interstitial cystitis
• Medicines such as water pills (diuretics)
• Overactive bladder syndrome
• Radiation therapy to the pelvis, used to treat certain cancers
• Stroke and other brain or nervous system diseases
• Tumor or growth in the pelvis
• Vaginitis 

Drinking too much before bedtime, especially caffeine or alcohol, can cause frequent urination at nighttime. Frequent urination may also just be a habit.

Home Care

Follow the therapy recommended by your health care provider to treat the cause of your urinary frequency or urgency. It may help to keep a diary of the times and amounts of urine you void to bring with you to your health care provider.

In some cases, you may experience urinary incontinence for a period of time. You may need to take steps to protect your clothing and bedding.

For nighttime urination, avoid drinking too much fluid before going to bed. Reduce the amount of coffee, other caffeinated beverages, and alcohol you drink.

Call your health care provider if

Call your health care provider right away if:

• You have fever, back or side pain, vomiting, or shaking chills
• You have increased thirst or appetite, fatigue, or sudden weight loss

Also call your health care provider if:

• You have urinary frequency or urgency, but you are not pregnant and you are not drinking excessive amounts of fluid
• You have incontinence or have changed your lifestyle because of your symptoms
• You have bloody or cloudy urine
• There is a discharge from the penis or vagina

What to expect at your health care provider's office

Your health care provider will take a medical history and perform a physical examination. Medical history questions may include:

• When did the increased urinary frequency start?
• How many times each day are you urinating?
• Are you urinating more often during the day or at night?
• Do you have an increased amount of urine?
• Has there been a change in the color of your urine? Does it appear lighter, darker, or more cloudy than usual? Have you noticed any blood?
• Do you have pain when urinating, or a burning sensation?
• Do you have other symptoms? Increased thirst? Pain in your abdomen? Pain in your back? Fever?
• Do you have trouble starting the flow of urine?
• Are you drinking more fluids than usual?
• Have you had a recent bladder infection?
• Are you pregnant?
• What medications are you taking?
• Have you had any past urinary problems?
• Have you recently changed your diet?
• Do you drink beverages containing alcohol or caffeine?

Tests that may be done include:

• Cystometry (a measurement of the pressure within the bladder)
• Cystoscopy
• Nervous system (neurological) tests (for some urgency problems)
• Ultrasound (such as an abdominal ultrasound or a pelvic ultrasound)
• Urinalysis
• Urine culture and sensitivity tests

Treatment depends on the cause of the urgency and frequency. Antibiotics and medicine may be prescribed to reduce your discomfort, if needed.

Prevention

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References

Drake M, Abrams P. Overactive bladder. In: Wein AJ, eds. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 66.

Zeidel ML. Obstructive uropathy. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 125.

Lentz GM. Urogynecology. Physiology of micturition, voiding dysfunction, urinary incontinence, urinary tract infections, and painful bladder syndrome. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, Pa: Saunders Elsevier; 2012: chap 21.