Unusual Urination Patterns: Possible Causes and Concerns

Urine output is significant, but the urge to urinate is not pronounced?

Hello Doctor, recently I have noticed that my urine output is quite substantial, but I do not experience any bladder distension or pain.
This is also the case for my first urination in the morning.
I have been keeping a simple record of my fluid intake and urination over the past few days, as shown in the linked document.
In the morning, I have urinated as much as 650 cc at once, and there have been several instances where I urinated a large volume (700-800 cc) within a short period of time, about an hour apart.
During this time, I do not feel the strong urge or discomfort in my lower abdomen that I used to experience with high urine volume; instead, I only feel a mild pressure.
Sometimes, I feel a sensation of nerve stimulation at the glans or a feeling of fullness in the penis, which prompts me to urinate, or I go at regular intervals.

The most peculiar incident occurred when I felt a mild pressure and experienced some leakage (on January 29th from 5:30 PM to 6:00 PM), after which I rushed to the bathroom and urinated 400 cc, followed by a dull ache in my lower abdomen.
Could this indicate nerve damage in the bladder, or is there another issue at play?

Xiao Chen, 30~39 year old female. Ask Date: 2021/01/29

Dr. Li Xinyi reply Urology

Typically, the bladder begins to signal the need to urinate when it contains over 200 cc of urine, and one should not wait until it reaches over 600 cc to relieve themselves and then check for any reactions.
There have been cases where patients have a habit of holding their urine, and eventually, their bladder can hold over 1000 cc without their awareness, leading to kidney function impairment and swelling in the legs, prompting them to seek medical attention.
Therefore, it is advisable to consult a urologist to check for any issues with residual urine and discuss further with the physician.

Reply Date: 2021/01/29

More Info

Understanding unusual urination patterns can be quite concerning, and it's important to explore the potential causes and implications of your symptoms. Based on your description, it seems you are experiencing a significant volume of urine output without the typical sensations of urgency or bladder fullness. This can be indicative of several underlying issues, and I will break down some possible explanations.

Firstly, the volume of urine you are producing, particularly the instances of 700-800cc within a short time frame, is noteworthy. Normal urine output for an adult is typically around 800 to 2000cc per day, depending on fluid intake. However, the absence of bladder distension or pain suggests that your bladder may not be functioning in the typical manner. This could be due to a few reasons:
1. Neurological Factors: If there is an issue with the nerves that control bladder function, it could lead to a condition known as neurogenic bladder. This can occur due to various reasons, including diabetes, multiple sclerosis, or spinal cord injuries. The sensation of "tingling" or "pressure" you describe could be related to nerve involvement.

2. Bladder Overactivity: Conditions such as overactive bladder (OAB) can cause increased frequency and urgency of urination, sometimes without the typical urge. However, OAB usually comes with a strong urge to void, which you do not seem to experience.

3. Diabetes Insipidus or Mellitus: If your body is unable to concentrate urine effectively, it could lead to excessive urination (polyuria). This is often accompanied by increased thirst. If you have a history of diabetes or other metabolic conditions, this could be a consideration.

4. Urinary Tract Infection (UTI): While UTIs typically cause urgency and discomfort, some individuals may experience atypical symptoms. The absence of pain does not rule out a UTI, especially if there are other signs of infection.

5. Psychogenic Factors: Sometimes, psychological factors can influence urination patterns. Stress or anxiety can lead to changes in how often one feels the need to urinate.

Given your symptoms, it is crucial to consult a healthcare professional who can perform a thorough evaluation. This may include:
- Urinalysis: To check for signs of infection, glucose, or other abnormalities.

- Bladder Diary: Continuing your record of fluid intake and output can help identify patterns.

- Neurological Assessment: If nerve involvement is suspected, a neurologist may need to evaluate your condition.

- Imaging Studies: An ultrasound or other imaging may be warranted to assess bladder structure and function.

In terms of immediate steps, I recommend:
- Monitoring Symptoms: Keep track of any changes in urination patterns, sensations, or any new symptoms that arise.

- Hydration: Ensure you are adequately hydrated, but be mindful of excessive fluid intake, which can exacerbate symptoms.

- Avoiding Irritants: Limit caffeine, alcohol, and spicy foods, which can irritate the bladder.

In conclusion, while your symptoms may not indicate a severe issue, they warrant further investigation to rule out any underlying conditions. A multidisciplinary approach involving urologists, neurologists, and possibly endocrinologists may be beneficial in diagnosing and managing your symptoms effectively. Always prioritize open communication with your healthcare provider to ensure a comprehensive evaluation and tailored treatment plan.

Similar Q&A

Understanding Frequent Urination and Anxiety-Related Symptoms

Hello, doctor. I have been experiencing frequent urination and difficulty urinating. My inability to urinate usually occurs when someone is nearby, so I believe it may be a psychological issue. However, after researching related conditions online, my anxiety has worsened, and the...

Dr. Chen Xiuyi reply Urology
Hello: The causes of frequent urination can be divided into two main categories. The first category involves increased urine production by the kidneys, which can occur due to physiological factors such as excessive fluid intake, consumption of coffee or alcohol, or as a result of...

Understanding Sudden Frequent Urination: Causes and When to Seek Help

Hello Doctor: I am a 26-year-old male, 180 cm tall, and weigh about 60 kg. I smoke, with a smoking history of one and a half years, averaging about a quarter of a pack per day. I have been exposed to secondhand smoke from my father since childhood. I rarely drink alcohol, about o...

Dr. Lin Hexing reply Urology
Based on your age, five years ago you were exactly twenty-one years old, and your prostate was still in the undeveloped stage, so it is unlikely to be diagnosed with benign prostatic hyperplasia (BPH). At this age, symptoms of frequent urination are more likely due to cystitis or...

Understanding Frequent Urination: Causes and Symptoms Explained

Frequent urination without increased fluid intake, along with feelings of fatigue, drowsiness, and occasional nausea, could be indicative of several underlying conditions. Possible causes may include diabetes mellitus, urinary tract infections, or kidney issues. It is important t...

Dr. Chen Jiansheng reply Urology
Hello, Miss Pudding: The causes of frequent urination are complex (infection, stones, emotions, medications, diet, etc.). I recommend that you visit the urology department for a urinalysis and treatment to gain a clearer direction. Chen Chien-Sheng, Urology Department, Hsin Ying ...

Understanding Unusual Urination Pain: Causes and Concerns

Hello Doctor: Recently, I have been experiencing lower back pain, which occasionally recurs. I am unsure of the cause of the back pain. Since last night, I have noticed something unusual with my urination. Initially, there was nothing particularly different, but towards the end o...

Dr. Du Shixi reply Urology
Hello: Symptoms such as lower back pain, incomplete urination, or painful urination are more likely to be associated with a urinary tract infection or kidney stones. However, a definitive diagnosis can only be made based on further examination results. Please drink plenty of wate...