Frequent Urination: Causes and Solutions for Relief

Q: Frequent Urination: Causes and Solutions for Relief

Hello： If urinary problems persist for more than six months, a series of examinations is necessary for diagnosis. <br>Please visit a major hospital's urology department for evaluation during a time when you are not menstruating. <br>Conditions such as psychogenic issues or overac

Frequent urination issues?

Hello Doctor: The symptoms started in high school after I experienced a urinary tract infection, which made me feel an intense urge to urinate while in the car, causing me significant distress.
At school, I have to go to the bathroom after every class, and sometimes I feel the urge to go even during class.
Each time, my urine volume is approximately between 50 to 200 cc.
I feel anxious when taking public transportation and hesitate to go out with family and friends.
During exams, the urge to urinate becomes even more unbearable, leaving me feeling powerless.
At home, I can go over two hours without needing to urinate, but I never exceed 200 cc at a time, and I only experience nocturia once at most.
My usual water intake is between 1000 to 1500 cc.
I have had urinary stones twice in the past and several urinary tract infections.
I would like to ask the doctor if this is psychogenic frequency or overactive bladder syndrome? If so, should I go to the hospital for an examination? I previously consulted a doctor at the hospital who said I was too young to worry, but this situation has persisted for six months, and I really want to overcome this issue.
I would appreciate your guidance, doctor.

Mu Mu, 10~19 year old female. Ask Date: 2020/10/18

Dr. Du Shixi reply Urology

Hello: If urinary problems persist for more than six months, a series of examinations is necessary for diagnosis.
Please visit a major hospital's urology department for evaluation during a time when you are not menstruating.
Conditions such as psychogenic issues or overactive bladder may not necessarily exist in isolation; it is possible to have neither or both.
Both conditions can be managed with medication.
Wishing you good health.

Reply Date: 2020/10/18

More Info

Frequent urination can be a distressing condition that significantly impacts one's quality of life. Based on your description, it appears that you have been experiencing this issue for quite some time, particularly since high school, which has led to considerable anxiety and discomfort. Your history of urinary tract infections (UTIs) and kidney stones may also contribute to your current symptoms.

Understanding Frequent Urination
Frequent urination, or polyuria, is defined as the need to urinate more often than usual. In your case, it seems to be accompanied by a sense of urgency and a relatively low volume of urine (50-200cc per visit). This can be indicative of several underlying issues, including:
1. Overactive Bladder (OAB): This condition is characterized by a sudden urge to urinate that may be difficult to control. It can lead to frequent urination during the day and night, often with little urine produced.

2. Psychogenic Factors: Anxiety and stress can exacerbate urinary symptoms. The fear of not being able to find a restroom, especially in social situations or during exams, can create a cycle of anxiety that worsens the urge to urinate.

3. Urinary Tract Infections (UTIs): Given your history of UTIs, it's possible that you may have a lingering infection or inflammation that is causing your symptoms to persist. Even after treatment, some individuals may experience residual symptoms.

4. Bladder Dysfunction: Conditions affecting the bladder's ability to store or empty urine properly can lead to frequent urination. This includes bladder inflammation or irritation, which may be caused by infections, stones, or other irritants.

Recommended Actions
Given your symptoms and history, it is advisable to seek further evaluation from a healthcare professional, preferably a urologist. Here are some steps you can take:
1. Comprehensive Evaluation: A urologist can perform a thorough assessment, including a physical examination, urinalysis, and possibly imaging studies (like an ultrasound) to rule out any structural abnormalities or ongoing infections.

2. Bladder Diary: Keeping a bladder diary for a few days can help track your fluid intake, urination frequency, and volume. This information can be valuable for your doctor in diagnosing the issue.

3. Behavioral Modifications: Techniques such as bladder training, which involves gradually increasing the time between urinations, can help manage symptoms of OAB. Additionally, pelvic floor exercises (Kegel exercises) may strengthen the muscles involved in urination.

4. Medication: If diagnosed with OAB or another condition, medications may be prescribed to help manage your symptoms. Anticholinergics and beta-3 adrenergic agonists are commonly used to treat OAB.

5. Psychological Support: If anxiety is a significant factor in your symptoms, consider speaking with a mental health professional. Cognitive-behavioral therapy (CBT) can be effective in addressing the anxiety associated with frequent urination.

Conclusion
Your symptoms of frequent urination, particularly in the context of past UTIs and kidney stones, warrant a thorough investigation to determine the underlying cause. While it may be tempting to dismiss these symptoms as a normal part of life, especially at a young age, it is essential to address them proactively. Seeking a urologist's expertise will provide you with the best chance of finding relief and improving your quality of life. Remember, you are not alone in this, and there are effective treatments available to help you manage your symptoms.

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