Frequent Urination: Causes and Diagnostic Discrepancies - Urology

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Frequent urination can be a perplexing issue, especially when accompanied by varying diagnostic results from imaging studies. Your situation, characterized by daytime frequency without nighttime urination, suggests a possible bladder or urinary tract issue, particularly given your history of laparoscopic surgery for endometriosis and the presence of mild hydronephrosis noted in your ultrasounds.

To address your question regarding the discrepancies between ultrasound and CT scan results, it's important to understand that different imaging modalities can provide varying levels of detail and may interpret anatomical structures differently. Ultrasound is highly sensitive to changes in fluid dynamics and can detect mild hydronephrosis, which is the swelling of a kidney due to a build-up of urine. However, CT scans, which provide a more comprehensive view of the abdominal and pelvic structures, may not always show mild hydronephrosis if the condition is transient or if the obstruction is not significant enough to cause noticeable changes in kidney size or shape. This discrepancy could also arise from differences in the timing of the scans, the patient's hydration status, or even the technique used during the imaging.

Regarding your concern about residual urine, the fact that your bladder was noted to contain a significant amount of urine after you had just voided could indicate a condition known as urinary retention. This can happen for various reasons, including bladder dysfunction, obstruction, or even neurological issues. In your case, the fact that you felt the need to urinate before leaving home but still had a full bladder upon examination suggests that your bladder may not be emptying completely. This could lead to feelings of urgency and frequency, as the bladder may signal the need to void even when it is not full.

Given your symptoms and the history of mild hydronephrosis, it would be prudent to follow up with a urologist for further evaluation. They may recommend additional tests such as a post-void residual (PVR) urine test to measure how much urine remains in your bladder after urination. This can help determine if you are experiencing urinary retention. Other diagnostic tools, such as urodynamic studies, can assess how well your bladder and urethra are functioning and may provide insights into the cause of your frequent urination.

It's also worth considering that hormonal changes from stopping oral contraceptives can affect your menstrual cycle and potentially influence urinary symptoms. Hormonal fluctuations can lead to changes in bladder sensitivity and function, which may contribute to your symptoms.
In summary, the discrepancies between ultrasound and CT results can stem from the nature of the imaging techniques and the timing of the studies. Your symptoms of frequent urination and the presence of residual urine warrant further investigation to rule out urinary retention or other underlying conditions. Consulting with a urologist for a comprehensive evaluation and possibly additional testing will be essential in determining the cause of your symptoms and guiding appropriate treatment.