Frequent Urination: When to See a Urologist

Hello, Dr. Chen?

This issue has been troubling me for a long time.
When I was around 22 to 23 years old, I visited a doctor, and at that time, my urine tests and blood sugar levels were almost normal.
The doctor suspected that my frequent urination might be caused by a urinary tract infection.
However, since I turned 28, the problem has worsened, and now I experience increased nighttime urination and urgency.
I drink very little water, at most 500cc, and I also consume about 500cc of tea.
My current weight is 50 kg.
The reason I hesitate to drink more is that as soon as I do, I feel the urge to urinate shortly after.
For example, a few days ago, I rode my bike to pick up a relative.
Before leaving, I drank a mug of water, and within about 20 minutes, I felt the urge to urinate.
When I did, the urine flow was rapid and abundant, clear and colorless.
While riding, due to the pressure from the seat and the road conditions, I felt an urgent need to stop at a gas station to urinate again, and the same thing happened—very large and rapid urination.
After picking up my relative, I experienced the same urgency on the way back home, and it wasn't until I got home that I felt a slight relief.

At night, while sleeping, I sometimes enter a light sleep state and immediately feel the urge to urinate, leading to frequent trips to the bathroom, sometimes as many as 10 to 20 times.
Occasionally, if I'm lucky and in a deep sleep, I might only wake up once to urinate and then sleep through until morning without feeling sticky.
However, the glans does feel a bit sticky, and the bathroom floor is also somewhat sticky.
I read in a news article that this could indicate diabetes, and I have a family history of diabetes—my father and sister both have it.
However, they do not experience the same excessive urgency that I do, although they do have some bladder sensations.
Therefore, I am unsure whether I should first consult a nephrologist or a urologist.

Mr. Chen, 30~39 year old female. Ask Date: 2022/09/14

Dr. Chen Jiansheng reply Urology

Urology

Reply Date: 2022/09/14

More Info

Frequent urination can be a distressing symptom that significantly impacts your quality of life. Given your history and the details you've provided, it’s essential to approach this issue systematically.
First, let's clarify what frequent urination entails. Typically, it refers to the need to urinate more often than usual, which can be classified as more than eight times in a 24-hour period. In your case, the urgency and frequency, especially at night (nocturia), suggest that there may be an underlying condition that needs to be addressed.

When to See a Urologist
You should consider seeing a urologist if you experience any of the following:
1. Persistent Symptoms: If your frequent urination persists despite lifestyle changes, such as fluid intake adjustments.

2. Associated Symptoms: If you experience pain during urination, blood in your urine, or any other unusual symptoms.

3. Impact on Daily Life: If your symptoms interfere with your daily activities or sleep, as in your case with nocturia.

4. Family History: Given your family history of diabetes, it’s prudent to investigate any potential metabolic issues that could be contributing to your symptoms.

Possible Causes
Frequent urination can stem from various causes, including:
- Urinary Tract Infections (UTIs): Although you mentioned previous tests were normal, UTIs can sometimes be tricky to diagnose, especially if they are recurrent.

- Diabetes Mellitus: As you noted, frequent urination can be a symptom of diabetes, particularly if your blood sugar levels are elevated. Given your family history, this is a significant consideration.

- Overactive Bladder: This condition is characterized by a sudden urge to urinate frequently, often with little warning.

- Prostate Issues: In men, prostate enlargement or inflammation can lead to urinary symptoms, although you mentioned not having issues with urination.

- Neurological Conditions: Conditions affecting nerve signals to the bladder can also lead to increased frequency.

Diagnostic Steps
1. Urinalysis: A simple urine test can help identify infections, blood, or glucose in the urine.

2. Blood Tests: Checking blood sugar levels and kidney function can provide insights into potential diabetes or other metabolic issues.

3. Bladder Diary: Keeping a record of your fluid intake and urination patterns can help your doctor understand your symptoms better.

4. Imaging Studies: If necessary, imaging studies like an ultrasound can help visualize the bladder and kidneys.

Treatment Options
Treatment will depend on the underlying cause identified through your evaluations. Here are some potential approaches:
- Lifestyle Modifications: Reducing caffeine and alcohol intake, managing fluid intake, and practicing bladder training techniques can help.

- Medications: If diagnosed with an overactive bladder, medications such as anticholinergics may be prescribed. If diabetes is diagnosed, managing blood sugar levels will be crucial.

- Physical Therapy: Pelvic floor exercises can help strengthen the muscles involved in urination.

- Surgery: In some cases, surgical options may be considered, particularly if there are anatomical issues contributing to the problem.

Conclusion
Given your symptoms and the potential implications, it would be advisable to see a urologist for a thorough evaluation. They can help determine whether your symptoms are due to a urological issue, a metabolic disorder like diabetes, or another underlying condition. Early diagnosis and treatment can significantly improve your quality of life and prevent further complications. Don’t hesitate to seek help; your health is paramount.

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