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:

• Anxiety
• Enlarged prostate
• Interstitial cystitis
• Medicines such as diuretics
• Overactive bladder syndrome
• Prostatitis (infection of the prostate gland)
• Stroke and other brain or nervous system diseases
• Tumor or mass in the pelvis
• Urinary incontinence
• Vaginitis

Less common causes:

• Bladder cancer
• Bladder dysfunction
• Radiation therapy to the pelvis, used to treat certain cancers
• Urinary tract fistula
• Diverticulitis

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

Home Care

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

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

Call your health care provider if

Call your doctor 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 doctor 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 altered 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?
• Is there more frequent urination 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 difficulty 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 previous urinary problems?
• Have you recently changed your diet?
• Do you drink beverages containing alcohol or caffeine?

Tests that may be done include:

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

Treatment is determined by the cause of the urgency and frequency. Antibiotics and medicine may be prescribed to lessen the discomfort, if needed.

Prevention

For nighttime urination, avoid excessive fluid before going to bed, particularly coffee, other caffeinated beverages, and alcohol.

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References

Carter C, Stallworth J, Holleman R. Urinary tract disorders. In: Bope ET, Rakel RE, Kellerman R, eds. Conn’s Current Therapy 2010. 1st ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 52.

Holroyd-Leduc JM, Tannenbaum C, Thorpe KE, Straus SE. What type of urinary incontinence does this woman have? JAMA. 2008 Mar 26;299(12):1446-56.

Foster RT Sr. Uncomplicated urinary tract infections in women. Obstet Gynecol Clin North Am. 2008 Jun;35(2):235-48, viii.

Barry MJ, McNaughton-Collins M. Benign prostate disease and prostatitis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 130.