Frequent Urination: Overactive Bladder or Incomplete Emptying?

Urinary retention? Frequent urination?

Hello, I visited the doctor due to frequent urination issues.
The doctor initially mentioned that it could be a recent bladder infection, which made my bladder more sensitive.
Later, I underwent an ultrasound and a urine volume and flow rate test (where I sat on a chair and urinated into a measuring container placed on a scale).
Ultimately, the doctor prescribed a medication for overactive bladder called Detrol (tolterodine), but only for 7 days, advising me to return based on my condition.
I am confused because if it is indeed overactive bladder, shouldn't it require long-term treatment? Why was I only given a 7-day supply and told to return as needed? My situation is that normally I can wait 2 hours between urinations, but during episodes of frequent urination, the intervals can be less than 30 minutes, although the urine volume is around 150 ml each time.
Could this indicate incomplete bladder emptying rather than overactive bladder? Additionally, I would like to ask if the side effect of constipation from Detrol is significant, as I have hemorrhoid issues and my frequent urination does not occur all day, so I haven't started the medication yet.

Ms. Chen, 30~39 year old female. Ask Date: 2019/01/03

Dr. Du Mingyi reply Urology

1.
A definitive diagnosis has not yet been established, so only a short supply of medication is prescribed until the diagnosis is confirmed and the treatment regimen is stabilized for a longer duration.

2.
Tests need to be conducted to determine if there is an issue with incomplete bladder emptying.

3.
The effects of the medication, including potential side effects, can only be assessed after it has been administered.

Reply Date: 2019/01/03

More Info

Frequent urination can be a complex issue, often stemming from various underlying conditions, including overactive bladder (OAB) or incomplete bladder emptying. Your situation, where you experience urgency and frequent trips to the bathroom, raises important questions about the nature of your symptoms and the appropriate treatment.

Overactive bladder is characterized by a sudden urge to urinate that may be difficult to control, often accompanied by increased frequency of urination. In contrast, incomplete emptying refers to the sensation of not fully emptying the bladder, which can lead to frequent urination as well. The distinction between these two conditions is crucial for determining the right treatment approach.

From your description, it seems that your doctor initially suspected a bladder infection, which can indeed cause increased sensitivity and urgency. However, after conducting further tests, including ultrasound and urinary flow studies, the diagnosis shifted towards overactive bladder, leading to the prescription of Detrusitol (tolterodine). This medication is commonly used to manage OAB symptoms by relaxing the bladder muscle, thereby reducing urgency and frequency.

Your concern about the short duration of the prescription (only seven days) is understandable. In many cases, medications for OAB are prescribed for longer periods, as they often require time to assess their effectiveness and adjust dosages. However, your doctor may have opted for a short trial to evaluate your response to the medication before committing to a longer course. This approach allows for monitoring of any side effects and determining if the medication effectively alleviates your symptoms.

Regarding your question about whether your symptoms could be due to incomplete emptying rather than OAB, it is indeed possible. The sensation of urgency combined with a relatively normal urine volume (150 ml) could suggest that your bladder is not emptying completely, leading to a feeling of needing to urinate more frequently. This could be due to various factors, including bladder dysfunction or even pelvic floor issues. If you suspect incomplete emptying, it would be wise to discuss this with your healthcare provider, as further evaluation may be necessary.

As for the side effects of Detrusitol, constipation is a known potential side effect of anticholinergic medications like tolterodine. The severity of this side effect can vary from person to person. If you have a history of hemorrhoids, it's essential to approach this medication cautiously, as constipation could exacerbate your condition. If you experience significant constipation while on Detrusitol, you should consult your doctor about possible alternatives or adjunctive treatments to manage this side effect.

In summary, frequent urination can stem from various causes, including overactive bladder and incomplete bladder emptying. Your current treatment plan with Detrusitol is a common approach for OAB, but if you have concerns about incomplete emptying or side effects like constipation, it is crucial to communicate these with your healthcare provider. They can help tailor your treatment plan to address your specific symptoms and improve your quality of life. Regular follow-ups will be essential to monitor your progress and make any necessary adjustments to your treatment.

Similar Q&A

Understanding Frequent Urination: Causes, Symptoms, and Treatment Options

Hello Doctor: I have been experiencing frequent urination for the past two weeks. Initially, I felt the urge to urinate a few minutes after finishing, and the volume was small. After a week, I drank three bottles of beer and noticed that I wanted to urinate again within seconds a...

Dr. Li Yilun reply Urology
Frequent urination may be diagnosed not only as a urinary tract infection but also as a symptom of other conditions, including kidney stones. Sexually transmitted infections should also be considered. Self-medicating with over-the-counter drugs is not the best approach; seeking m...

Understanding Frequent Urination: Causes and Solutions for Young Adults

Hello, doctor. I am currently 20 years old, and recently I have been experiencing a feeling of incomplete bladder emptying when I urinate. However, I tend to forget about this feeling quickly when I engage in other activities. I would like to know if this could be caused by psych...

Dr. Du Shixi reply Urology
Hello: It is likely a temporary sensation. Drink less beverages, engage in gentle exercise, and avoid prolonged sitting. Wishing you good health.

Understanding Frequent Urination: Causes and Solutions

I have been experiencing frequent urination for the past two to three months. Aside from sleeping, I constantly feel the urge to urinate. When I am focused on something, I might forget about it, but then the urge suddenly returns. I don't feel particularly stressed, but this...

Dr. Sun Hongshun reply Urology
Hello, I would like to know if you are taking any medications. If not, the possibility of overactive bladder cannot be ruled out. I recommend visiting a urology clinic for further evaluation. Wishing you good health.

Understanding Overactive Bladder: Managing Frequent Urination and Anxiety

Hello, doctor. Recently, I started experiencing frequent urination, going to the bathroom 8-10 times a night, and I had severe pain in my urinary tract that made me roll in bed. I visited Fu Jen Catholic University Hospital, where the doctor diagnosed me with a urinary tract infe...

Dr. Du Shixi reply Urology
Hello: If there are so many hospitals conducting examinations and all items are complete with no issues, there should be no problems with the urinary organs. However, during the consultation period, medication should have been prescribed, which usually has a noticeable effect. If...