Urgent urination; Urinary frequency or urgency

Together, frequent and urgent urination are classic signs of a urinary tract infection. Since inflammation reduces the bladder's capacity to hold urine, even small amounts of urine cause discomfort.

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

Other causes include:

• Interstitial cystitis
• Medicines such as diuretics
• Overactive bladder syndrome
• Stroke and other neurological diseases

Less common causes:

• Bladder cancer
• Bladder dysfunction
• Radiation therapy

Common causes of nighttime urination:

• Drinking too much before bedtime, especially caffeine or alcohol
• Enlarged prostate

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 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

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.

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

Speakman MJ. Guideline for the primary care management of male lower urinary tract symptoms. BJU Int. 2004; 93(7): 985-990.

Bass PF. Urinary tract infections. Prim Care. 2003; 30(1): 41-61, v-vi.