Frequent Urination

FREQUENT URINATION

Frequent urination means having an urge to pass urine more often than usual. It can disrupt one's normal routines, interrupt the sleep cycle, but it can also be a sign of an underlying medical condition.

Many people live with frequent urination, (which is known medically as frequency). When one urinates more than 3 liters a day of urine, it is known as polyuria. Often, there is a simple cause that can be put right through treatment.

Frequency is not the same as urinary incontinence, where a person urinates when they do not want to.

Sometimes, frequent urination can be indicative of a more serious condition. Early identification of the problem can lead to a timely and effective treatment and prevent possible complications.

Some fast facts on frequent urination:

• Urinary frequency can be defined as needing to urinate more than 7 times in a period of 24 hours while drinking about 2 liters of fluid.
• Most people urinate 6 or 7 times on the average in 24 hours. Urinating more often than this may be referred to as frequency, though everyone is different.
• Normally it becomes a problem only if it affects a person's quality of life.
• Frequency can often be treated with exercises, but if there is an underlying condition, such as diabetes, this will need attention.
• Urinary frequency is when a person needs to use the bathroom more often than usual.
• Urination is the way the body gets rid of waste fluids. The kidneys play a key role in this process. Urine contains water, uric acid, urea, and toxins and waste filtered from within the body.
• Urine stays in the bladder until it reaches a point of fullness and an urge to urinate. At this point, the urine is expelled from the body.
• Urinary frequency just means needing to visit the bathroom to urinate more often. It can occur alongside urinary incontinence, but they are not the same.

However, individuals differ, and most people only see a doctor when urination becomes so frequent that they feel uncomfortable. Children, too, have smaller urinary bladders, so it is normal for them to urinate more frequently.

Who experiences frequent urination?

Everyone feels the need to urinate at one time or the other, except that this shared experience isn't always consistent. Sometimes one may need to urinate much more often than what is normal. This can happen to anyone, men, women, and even children can all have this symptom. However, it becomes more common at certain times in life or when other conditions arise.

People are more likely to urinate frequently if they're:

• Have an enlarged prostate
• A middle-age or old adult
• Pregnant

CAUSES OF FREQUENT URINATION

Frequent urination can be a symptom of many different problems from kidney disease to simply drinking too much fluid. A person may have a urinary tract infection when frequent urination is accompanied by fever, an urgent need to urinate, and pain or discomfort in the abdomen.

Depending on the cause of the frequent urination, one may experience other urinary problems, such as:

• Unusual urine color
• Difficulty urinating
• Pain or discomfort during urination
• A strong urge to urinate
• Loss of bladder control

Specific diseases, conditions or other causes of frequent urination include:

• Anterior prolapse (cystocele) : Also called a prolapsed bladder, it is when the bladder drops from its normal position
• Anxiety disorders - Panic, fear, and uneasiness Feelings of panic, doom, or danger Sleep problems Not being able to stay calm
• Benign prostatic hyperplasia (BPH) - A noncancerous increase in size of the prostate gland.
• Bladder stones - Hard masses of minerals in the bladder. This often happens when emptying the bladder completely becomes a problem.
• Change in kidney function - Ageing is associated with significant changes in structure and function of the kidney
• Diabetes insipidus - An uncommon disorder that causes an imbalance of fluids in the body.
• Diuretics (water retention relievers) - Medications designed to increase the amount of water and salt that is expelled from the body as urine.
• Excess consumption of total fluids, alcohol or caffeine : It is possible to drink too much water. When the kidneys cannot excrete the excess water, the sodium content of the blood is diluted. This can be life threatening.
• Interstitial cystitis (also called painful bladder syndrome) - A chronic condition causing bladder pressure, bladder pain and sometimes pelvic pain.
• Kidney infection (pyelonephritis) - Inflammation of the kidney, typically due to a bacterial infection.
• Overactive bladder - The name for a group of urinary symptoms. It is not a disease. The most common symptom is a sudden, uncontrolled need or urge to urinate
• Radiation treatment affecting the pelvis or lower abdomen - Radiotherapy to the lower abdomen or pelvis can affect one's fertility and sex life.
• Type 1 diabetes - A chronic condition in which the pancreas produces little or no insulin
• Type 2 diabetes - A chronic condition that affects the way the body metabolizes sugar (glucose), an important source of fuel for the body.
• Urethral stricture (narrowing of the urethra) - A stricture restricts the flow of urine from the bladder and can cause a variety of medical problems in the urinary tract
• Urinary incontinence - The involuntary leakage of urine. It means a person urinates when they do not want to.
• Urinary tract infection (UTI) - An infection in any part of the urinary system (i.e. the kidneys, ureters, bladder and urethra).
• Vaginitis - An inflammation of the vagina that can result in discharge, itching and pain.

Other possible causes of frequent urination include:

Right from the early weeks of pregnancy the growing uterus places pressure on the bladder, causing frequent urination.

• Prostate problems.

An enlarged prostate can press against the tube that carries urine out the body (the urethra) and block the flow of urine. The bladder begins to contract even when it contains small amounts of urine, causing frequent urination.

• Interstitial cystitis.

With an unknown cause, this condition is characterized by pain in the bladder and pelvic region. Often, symptoms include an urgent and/or frequent need to urinate.

• Stroke or other neurological diseases.

Damages to nerves that supply the bladder could also lead to problems with bladder function, including frequent and sudden urges to urinate.

The under listed are causes but which are less common. They include;  

• Bladder cancer - Cancer that begins in the cells of the bladder
• Bladder dysfunction - Refers to problems with urination
• Radiation therapy - The use of beams of intense energy to kill cancer cells.

Often, frequent urination is not the symptom of any problem, instead, frequent urination is the problem itself. In people with overactive bladder syndrome, involuntary bladder contractions lead to frequent and often urgent urination. So that even if the bladder is not full, it may also lead to waking up once or more during the night to use the bathroom.

SYMPTOMS

One of the main symptoms of polyuria is frequent urination. If there are other symptoms, they may indicate possibly a more serious condition.

Nocturia, for example, is the need to urinate at night, during the sleep cycle. This can be a symptom of diabetes insipidus or diabetes mellitus.

Other symptoms that may need further attention include:

• Nausea or vomiting
• Discharge from the vagina or penis
• Pain or discomfort while urinating
• Bloody or cloudy Urine, or urine of an unusual color
• Gradual loss of bladder control, or urinary incontinence
• Difficulty urinating despite the urge
• An increase in appetite or thirst
• Fever or chills
• Low back or side pain

Frequent urination can also indicate a kidney infection. If left untreated, this could permanently damage the kidneys. Additionally, the bacteria that cause the infection can potentially enter the bloodstream, infecting other areas of the body.

WHEN TO SEE A DOCTOR

People must schedule appointments with their doctor if they are urinating more frequently than usual and if:

• The problem disrupts one's sleep or everyday activities
• There happen to be no apparent cause (e.g. drinking more total fluids, alcohol or caffeine)
• one have other urinary problems or worrisome symptoms

Contact a doctor as soon as possible if frequent urination is experienced along with any of the following signs and symptoms:

• A strong urge to urinate
• Painful urination
• Bloody urine
• Red or dark brown urine
• Pain in the side, lower abdomen or groin
• Difficulty urinating or emptying the bladder
• Loss of bladder control
• Fever

Urinary tract disorders may cause the signs and symptoms listed above, but so can other serious diseases or health conditions. Therefore people must seek medical help to find out the cause of the frequent urination and how best to treat it.

DIAGNOSIS

A thorough history and physical examination will have to be carried out by a doctor, who may ask the patient about frequency of urination and about other symptoms.

The doctor may ask about:

• When it began,
• What time of day it occurs
• Changes in color, smell, or consistency of the urine
• The pattern of frequent urination
• Current medications
• How much fluid the patient consumes
• How much caffeine and alcohol the individual consumes
• Is the person taking any medications?
• Is he/she experiencing other symptoms?
• Does he/she have the problem only during the day or also at night?
• Is the urine darker or lighter than usual?

Tests may include:

Depending on the findings of the physical exam and medical history, the doctor may order some tests which may include:

• Urinalysis

The microscopic examination of urine that also involves a number of tests to detect and measure various compounds that pass through the urine.

• Cystometry

This test measures the pressure inside of the bladder to see how well the bladder is working; this is to determine if a muscle or nerve problem may be causing problems with how well the bladder holds or releases urine.

• Cystoscopy

This test allows the doctor to look at the inside of the bladder and urethra through a thin, lighted instrument called a cystoscope. There is a broader testing regimen called urodynamic, this is a study that assesses how the bladder and urethra are performing their job of storing and releasing urine. That includes tests such as cystometry, Uroflowmetry, urethral pressure and others.

• Neurological Tests

Diagnostic tests and procedures that help the doctor confirm or rule out the presence of a nerve disorder.

• Ultrasonography

A diagnostic imaging test using sound waves to visualize an internal body structure. Patients may be referred to an urologist, or a woman may be referred to a gynecologist.

• Urodynamic tests

Urodynamic tests assess the effectiveness of the urinary bladder in storing and releasing urine, they also examine the function of the urethra.

Simple observations during this test include:

• Gauging the ability to stop urinating mid-stream
• Recording the time it takes to produce a urinary stream
• Noting the amount of urine produced

To obtain precise measurements, the health professional may use:

• Sensors that record muscle and nerve activity
• Appropriate imaging equipment to observe the bladder filling and emptying
• Monitors that measure pressure inside the bladder

The individual may have to stop taking certain medications before the test. They may need to arrive at the clinic with a full bladder.

TREATMENT

Treatment for frequent urination will address the underlying problem that is causing it. So that, if diabetes is the cause, the treatment will involve keeping blood sugar levels under control.

The treatment for overactive bladder should begin with behavioral therapies, such as:

• Monitoring fluid food intake

People should drink enough, first to prevent constipation and secondly to avoid over-concentration of urine. Refrain from drinking just before bedtime, this can lead to nighttime urination.

• Retraining the bladder

This helps retrain the bladder to hold urine longer and to urinate less frequently. It involves increasing the intervals between using the bathroom over the course of about 12 weeks.

• Modification of diet

Avoid food that appears to irritate the bladder or acts as a diuretic. These may include artificial sweeteners, caffeine, alcohol, carbonated drinks, chocolate, and spicy foods. Since constipation can make frequent urination worse, It becomes important to eat high-fiber foods.

• Kegel exercises

These are special exercises that help strengthen the muscles around the bladder and urethra to improve bladder control and reduce the urgency and frequency of urination.  Exercising the pelvic muscles for five minutes, three times a day can make a big difference in bladder control.

PREVENTION

To prevent frequent urination, people should eat balanced diets and maintaining active lifestyles. This can help in the moderation of urine output. In reality, it may mean limiting alcohol and caffeine intake and cutting out foods that can irritate the bladder or act as a diuretic, such as chocolate, spicy foods, and artificial sweeteners.

Eating high-fiber foods also helps to reduce constipation, and may indirectly improve urine flow through the urethra. This is because a constipated rectum can put pressure on the urinary bladder or the urethra, or both of them.

CONTROLLING FREQUENT URINATION

There are several lifestyle changes and non-medicated ways to manage frequent urination. These can include:

• Refraining from drinking fluids before going to bed.
• Limiting the amount of alcohol and caffeine intake
• Doing Kegel exercises that target the muscles that support the organs in the pelvis, including the bladder
• A short-term solution of wearing a protective pad or underwear to avoid possible leaks.