Frequent Urination

1 Frequent Urination Summary

Frequent urination, or polyuria, is the urge to empty the bladder more often than normal. It causes considerable discomfort and may affect sleep, as the person has to get up often to pass urine.

Frequent urination can be a symptom of an underlying medical condition. Most of the people do not consider this as a serious condition and may not discuss the same with the doctor.

Some others do not raise the issue with doctors thinking it is a serious disease. Frequent urination may not be a serious issue and people with this condition can return to normal with diagnosis and treatment.

Under normal conditions, a person excretes about 1-1.8 L of urine in a day. The urge to pass urine may be sudden, and this may be accompanied by discomfort in the bladder.

Some people will have to get up in the night more than once to relieve themselves, a condition the called as nocturia. It is seen in both men and women. Nocturia affects sleep and thus the quality of life of a person.

Frequent urination is different from urinary incontinence in that the latter refers to the absence of voluntary control of the bladder. But, urinary incontinence can be a cause of polyuria.

In many cases, the two conditions occur together. Although frequent urination is not of concern in many cases, some of the accompanying symptoms warrant medical attention. This includes

Although frequent urination is not of concern in many cases, some of the accompanying symptoms warrant medical attention, this includes: 

There are multiple causes for frequent urination, including neurological, psychological, and physical. It ranges from a simple habit as drinking more fluids to bladder cancer.

Diabetes, pregnancy, and prostate problems are the most common causes of polyuria. It may also be caused by anxiety, kidney infection, stroke, urinary incontinence, diverticulitis, and infection of the prostate gland. 

For diagnosis of cause, medical history, physical examination, and associated symptoms are of help. Information on the pattern of polyuria like onset, frequency and time of occurrence are noted.

Current medications, other symptoms, fluid intake, changes in urine, and intake of alcohol and caffeine are also evaluated during the diagnosis. Further tests and investigations are based on the initial examination and probable cause of this symptom. Other tests suggested include

Other tests suggested include: 

  • Urine analysis
  • Neurological tests
  • Urodynamic tests
  • Imaging studies

In urodynamic tests, filling and emptying of the bladder are observed using specialized equipment. It also measures the pressure inside the bladder along with the functioning of nerves and muscles.

Treatment is based on the underlying cause of frequent urination. Keeping diabetes under control helps to reduce the frequency of urination. Antibiotics are used to treat kidney infection that leads to polyuria.

Medications and behavioral techniques are recommended for overactive bladder. Anticholinergics help to reduce the over-activity of detrusor muscles in the bladder. Other treatment methods like Kegel exercises, biofeedback, bladder training, and diet also help in controlling this symptom.

Quitting smoking and maintaining a healthy body weight are the best techniques to prevent frequent urination. Avoiding alcohol, coffee, tea, and certain other foods also aid in preventing frequent urination.

2 Causes

Urinary tract infection (UTI) is one of the most common causes of frequent urination. It is more common among women when compared to men, due to the smaller size of the urethra in women.

Polyuria may be caused by and overactive bladder. Overactive bladder is characterized by a group of symptoms that can increase the frequency of urination. It includes urge incontinence, urinary urgency, and nocturia.

Some other causes of frequent urination are:

  • Diabetes
  • Pregnancy
  • Increased intake of fluids
  • Intake of caffeinated or alcoholic beverages
  • Anxiety
  • Diuretics
  • Prostate enlargement
  • Overactive bladder
  • Vaginal infection

It may also be caused by stroke, tumor, bladder cancer, urinary tract injury, diverticulitis, and radiation therapy in the pelvic region.

UTI – UTIs are caused by bacterial infection of any of the part of the urinary tract. It is the second most common infections in humans. It also causes back pain, fever, and nausea.

Urge incontinence – it refers to the sudden urge to pass urine. In this condition, the sudden contraction of bladder leads to leakage of urine through the sphincter muscles.

Prostate enlargement – enlargement of prostate glands beyond the normal size causes frequent urination in men.

Kidney stones – small, crystallized mass of calcium and other substances pass through the urinary tract, causing pain and frequent urination.

Menopause – it marks the cessation of menstruation in women and is a common cause of frequent urination in women. It is associated with hot flashes, vaginal dryness, and frequent urination as symptoms.

Bladder stones – small stones formed from by crystallization of minerals left in the bladder are called bladder stones. These stones also increase the frequency of urination, when present.

Urethritis – irritation and inflammation of the urethra, the tube that carries urine from the bladder to the outside, is called urethritis. Frequent urination is a symptom of this condition.

Overactive bladder – this is a chronic condition in which there is a sudden urge to urinate even when the bladder is not full. This sudden urge results in polyuria.

Interstitial cystitis – it refers to the chronic inflammation of the bladder. Pelvic pain, urinary incontinence, and polyuria are the symptoms of this condition.

Neurogenic bladder – it is a condition characterized by a lack of signals from the brain that controls urination. This causes frequent urination.

Prostatitis – inflammation of prostate glands is referred to as prostatitis. It causes back pain, pain while urination and frequent urination in men.

Urethral stricture – narrowing of the urethral tube that restricts the flow of urine is known as a urethral stricture. Frequent urination is a symptom of this condition.

Pyelonephritis – inflammation of the kidney and upper part of the urinary tract is known as pyelonephritis. Apart from flushed skin, back pain, fever, and nausea, it increases the frequency of urination.

Bladder cancer – although not so common, bladder cancer may also cause polyuria in some people.

Hydronephrosis – swelling of the kidney due to improper drainage of urine from the organ to urinary bladder is known as hydronephrosis. This condition is also implicated in the development of frequent urination.

Ovarian cancer – cancer in one of the ovaries may lead to frequent urination.

Multiple sclerosis – this autoimmune condition affects the central nervous system and is implicated in the development of polyuria in some patients.

3 Diagnosis and Treatment

Medical history and physical examination are the first steps in the diagnosis of the underlying cause of the symptom.

Details of the symptom like the frequency of urination, the time during which the symptom is seen, changes in urine-like color, discomfort during urination, dietary changes, and other accompanying symptoms provide important clues regarding the probable cause of frequent urination.

Other tests and investigations for further confirmation are suggested after considering the medical history and physical examination.

Other tests suggested include: 

Urine analysis – this helps to determine the presence of abnormal content in urine like bacteria or blood cells.

Neurological tests – these tests are suggested to determine disorders of nervous system if any.

Imaging studies – these provide a better picture of the structure and functioning of the internal organs.

Urodynamic tests – these tests help to evaluate the functioning of the bladder, sphincters, and urethra in storing and releasing urine. This study is used to measure the amount of urine produced, and to evaluate the filling and release of urine. Sensors are used to measure the activity of muscles and nerves in the bladder. They also have monitors to measure the pressure within the bladder.

Cystoscopy – this is an invasive procedure to check the structure and functioning of bladder and urethra.

Treatment method suggested depend on the underlying condition: 

  • Antibiotics are prescribed for urinary tract infections. Increasing the fluid intake also helps to control the condition.
  • Controlling the blood sugar levels through medications and diet brings down the frequency of urination in diabetes.
  • Diuretics are useful in controlling the symptom, particularly in the night.
  • Medications, 5-alpha-reductase inhibitors and alpha blockers, are used to treat prostate problems. Surgery is recommended in certain cases to control the symptom.
  • Frequent urination is common during pregnancy. Reducing the intake of caffeinated fluids during this time helps to control the frequency.
  • Interstitial cystitis is treated with medications like tricyclic antidepressants, painkillers, and pentosan polysulfate sodium.
  • Neurological disorders that cause frequent urination are treated with medications and behavioral therapy.
  • Surgery, chemotherapy, and radiation therapy are suggested for treatment of bladder cancer.
  • Overactive bladder is treated with medications and bladder training.

In the absence of an underlying medical condition, frequent urination can be controlled by home care, this includes:

Kegel exercises – these exercises focus on contraction and relaxation of the muscles in the pelvic floor. These exercises improve bladder control and reduce the frequency and urgency of urination.

Diet – avoid caffeinated beverages, artificial sweeteners, and spicy foods. Have a high-fiber diet to avoid constipation.

Fluid intake – monitor the intake of fluid so as to avoid constipation but have enough for metabolism. Avoid drinking more fluids during night time so that sleep is not disturbed due to frequent urination.

Bladder training – it is helpful in overactive bladder conditions and involves holding urine for slightly longer duration than normal. The interval during which it is held back is increased gradually over a period. This helps to retain urine for a longer duration.

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