Frequent Urination: Causes and Concerns in Daily Life - Urology

Dr. Cai Zongyou reply Urology

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Hello: The normal bladder capacity for an adult is approximately 350 to 400 milliliters.
If we consider an average daily fluid intake of 2000 milliliters, the normal frequency of urination should be about five to six times a day.
Therefore, if the number of times one urinates in a day significantly exceeds this, it can be termed as polyuria.
What causes the symptoms of polyuria? As mentioned above, it can be inferred that polyuria is related to factors such as fluid intake, bladder capacity, and bladder function.
I will categorize and summarize several common causes of polyuria as follows:
1.
Psychological Issues: Individuals who are prone to anxiety, stress, or nervousness may experience dysregulation of the autonomic nervous system, leading to polyuria.
Symptoms may typically occur during specific times, such as during the day or just before falling asleep at night, and may disappear with rest or sleep.
This type of patient is most commonly seen among children and working women.
2.
Urinary Tract Infections: Conditions such as urethritis, cystitis, and prostatitis can cause inflammation that makes the bladder lining very sensitive.
Even a small amount of urine can trigger a sense of urgency, but when actually urinating, only a small amount of urine may be produced.
Patients often experience difficulty urinating, pain, burning sensations, and discomfort in the lower abdomen.
3.
Bladder Dysfunction: Conditions referred to as "overactive bladder" or "unstable bladder" are caused by involuntary contractions of the bladder detrusor muscle for unknown reasons, resulting in symptoms such as polyuria, urgency, and even incontinence.
True "bladder weakness" refers to the detrusor muscle's inability to contract effectively, leading to excessive residual urine and decreased effective bladder capacity, which in turn causes polyuria.
Additionally, infections caused by tuberculosis or schistosomiasis, as well as chronic cystitis following radiation exposure, can lead to fibrosis of the bladder wall, significantly reducing its elasticity and capacity, resulting in polyuria.
4.
Male Issues: Obstruction in the lower urinary tract (from the bladder to the urethral outlet), such as benign prostatic hyperplasia, prostate cancer, bladder stones, or urethral stricture, can prevent urine from being expelled effectively, leading to excessive residual urine and decreased effective bladder capacity, resulting in polyuria, nocturia, and difficulty urinating.
5.
Female Issues: The uterus and ovaries are located directly behind the bladder, so certain gynecological conditions such as uterine fibroids, ovarian cysts, or uterine prolapse can indirectly compress the bladder, making it difficult for the bladder to expand.
Additionally, pelvic inflammatory disease or vulvitis can indirectly affect the bladder, causing symptoms similar to urinary tract infections, such as polyuria and lower abdominal pain.
Furthermore, "menopausal syndrome," which troubles many women of middle age and older, often includes complaints of polyuria.
6.
Internal Medical Conditions: Diabetes is characterized by the "three Ps": polyphagia, polydipsia, and polyuria, with polyuria being one of the many symptoms.
Diabetes insipidus, caused by a pituitary tumor or kidney disease, results in the body's inability to concentrate urine, leading to excessive urination and polyuria.
Additionally, if antihypertensive medications contain diuretics, they can also cause frequent urination within a few hours after taking the medication.
7.
Neurological Issues: Conditions such as stroke, dementia, spinal cord injury, or peripheral neuropathy can lead to varying degrees of urinary dysfunction.
Differential diagnosis requires detailed neurological examinations and urodynamic studies.
There are numerous causes of polyuria, and it is possible for multiple factors to be involved, potentially spanning fields such as psychiatry, gynecology, neurology, and internal medicine.
I hope this article helps the public gain a preliminary understanding of where their issues may lie.
As for treatment options, I encourage everyone to discuss their concerns with a physician in a urology clinic.

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Reply Date: 2009/02/16