Frequent Urination and Low Urine Volume: Infection vs. Overactive Bladder

Q: Frequent Urination and Low Urine Volume: Infection vs. Overactive Bladder

Hello： 1. If you feel the urge to urinate, it's okay to wait about half an hour. During your follow-up visit, a urine test will provide more information (please inform your doctor if you are taking other medications). 2. If you feel the urge to urinate in

Frequent urination with low urine volume (infection vs. overactive bladder)

Hello Doctor: This issue has been troubling me for a long time.
I have been experiencing frequent urination every time I go to the bathroom, and I’m not sure when it started...
About a year ago, I had a severe episode of frequent urination, needing to go every few minutes.
At that time, the doctor diagnosed it as an infection, which was treated, but I still returned to my original level of frequency.
I urinate at least 10 times a day (I haven't counted precisely), and recently, I felt the urge to urinate in less than 30 minutes.
The doctor examined me and found an infection, so I took a week's worth of medication (I had two visits, but the second visit did not include a urine test, so I only took the medication for a week).
Later, I consulted another doctor who reviewed my test results and said I was cured (showing me the report with no abnormalities).
However, my symptoms remain the same, with the urge to urinate every 30 minutes.
The doctor prescribed another week's supply of Mirabegron.
Upon my follow-up visit, my symptoms persisted.
Before the appointment, I measured my urine output several times, which ranged from 80 to 150 cc, with 150 cc being when I was holding my urine a bit, as the doctor advised me to hold it a little.
This time, the doctor suggested it might be overactive bladder.
I would like to ask the doctor: 1.
The doctor who is currently treating me has prescribed another two weeks of medication, and I will return for a follow-up.
I have been trying to hold my urine a bit, but I am unsure how much is appropriate, as I am afraid of getting another infection.
Is it possible that I have an infection again by the time of my next visit? 2.
I do not have nocturia, but I always urinate before going to bed and in the morning.
Sometimes, I wake up feeling the urge to urinate but am too groggy to get up, so I hold it and fall back asleep.
Could this lead to an infection? 3.
Sometimes I feel like I haven't completely emptied my bladder, even though I have finished urinating, and I quickly feel the urge again.
Am I being too sensitive, or should I try to urinate again? 4.
The doctor mentioned further tests will be needed; is there anything I should prepare for? 5.
After measuring my urine output, I noticed that while my volume seems low, the frequency is high—at least once an hour, and if I drink water, it’s every 30 minutes (or even less than 30 minutes).
6.
I previously experienced severe constipation and occasionally have mild constipation now, possibly due to internal hemorrhoids, but I have improved since eating black fungus.
Does this have any impact on my urinary issues? (My stool has many tiny bubbles, and there are white or clear substances on it.) 7.
I apologize for bothering you, doctor.

Claire, 20~29 year old female. Ask Date: 2017/05/28

Dr. Du Shixi reply Urology

Hello:
1.
If you feel the urge to urinate, it's okay to wait about half an hour.
During your follow-up visit, a urine test will provide more information (please inform your doctor if you are taking other medications).

2.
If you feel the urge to urinate in the morning, you should go, as the urine volume is usually significant.

3.
Many factors can cause the urge to urinate, such as beverages, insufficient water intake, and stress.
Therefore, it's important to maintain a balanced fluid intake; the amount should not be too low, and the urine color should appear light (dark urine usually indicates dehydration).
Avoid beverages, alcohol, and spicy foods.
Aim to walk for half an hour each day.

4.
No need for additional measures; just pay attention to your lifestyle and drink more water.

5.
You can keep a record yourself; there are urinary diaries available online.
Try to document for 1-3 days for an objective assessment.

6.
It's okay.

Reply Date: 2017/05/28

More Info

Frequent urination and low urine volume can be quite distressing and may stem from various underlying conditions, including urinary tract infections (UTIs) or overactive bladder (OAB). Given your history of recurrent urinary symptoms and the treatments you've undergone, it’s essential to explore these issues in detail.

1. Understanding Your Symptoms: Your experience of needing to urinate every 30 minutes, along with low urine volume (80-150 cc), suggests that your bladder may be overactive. Overactive bladder is characterized by a sudden urge to urinate that can be difficult to control, often leading to increased frequency and urgency. On the other hand, recurrent UTIs can also cause similar symptoms, including urgency and frequency, as well as discomfort during urination. Since your urine cultures have returned negative for bacteria, it is less likely that you are currently experiencing a UTI, but it’s important to monitor for any signs of infection, such as fever or increased pain.

2. Managing Urination: When it comes to holding your urine, it’s generally advisable to respond to your body’s signals. While it’s okay to hold it for a short period, consistently delaying urination can lead to bladder distension and potential infections. If you are concerned about the possibility of another infection, it’s best to communicate this with your healthcare provider. They may recommend regular follow-ups or additional testing to ensure that your urinary tract remains healthy.

3. Nighttime Urination: You mentioned that you do not experience nocturia (waking up at night to urinate), which is a good sign. However, if you feel the urge to urinate in the morning but are unable to get up, it’s unlikely to cause an infection as long as you are not holding it for excessively long periods. It’s important to maintain good hydration throughout the day, as this can help dilute your urine and reduce irritation in the bladder.

4. Feeling of Incomplete Emptying: The sensation of not fully emptying your bladder can be frustrating. This feeling can be due to several factors, including bladder sensitivity or muscle control issues. If you consistently feel the need to urinate shortly after going, it may be beneficial to discuss this with your doctor, as they may suggest bladder training techniques or medications to help manage your symptoms.

5. Further Testing: Your doctor has indicated that further testing may be necessary. This could include urodynamic studies, which assess how well your bladder and urethra are functioning, or imaging studies to rule out any anatomical issues. Preparing for these tests usually involves following specific instructions from your healthcare provider, such as drinking a certain amount of fluid before the test or avoiding specific medications.

6. Impact of Constipation: Your history of constipation can indeed affect urinary function. The rectum and bladder are closely related anatomically, and significant constipation can lead to increased pressure on the bladder, potentially exacerbating urinary symptoms. Maintaining a healthy diet rich in fiber, as you have done with black fungus (木耳), can help alleviate constipation and may indirectly improve your urinary symptoms.

7. Conclusion: It’s crucial to maintain open communication with your healthcare provider regarding your symptoms and any changes you notice. Keeping a bladder diary, where you track your fluid intake, urination frequency, and volume, can provide valuable information for your doctor. This can help in diagnosing whether your symptoms are due to an overactive bladder, residual effects of a previous infection, or another underlying issue.
In summary, while your symptoms may suggest overactive bladder, it’s essential to rule out any infections or other conditions through appropriate medical evaluation. Your proactive approach to managing your symptoms and seeking medical advice is commendable, and I encourage you to continue working closely with your healthcare provider to find the best management plan for your situation.

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