Persistent Urinary Frequency: Causes and Solutions

Q: Persistent Urinary Frequency: Causes and Solutions

Hello： Based on your symptoms and normal urine test results, it appears to be a case of overactive bladder, a modern civilization ailment. <br>In addition to adjusting your lifestyle, medication can also lead to gradual improvement. <br>Regarding lifestyle adjustments, including

The issue of frequent urination has persisted for over a month?

Hello Dr.
Lin,
I have been experiencing frequent urination for nearly two months, needing to urinate approximately once every hour.
If I drink 200-350cc of water at once, I need to use the restroom again within about half an hour.
The symptoms appeared suddenly and are accompanied by other issues.
In addition to daytime frequency, I also experience post-void residual urine and nocturia (waking up due to bladder fullness) about 2-3 times on average at night.
During this time, I have had two episodes of chills, occasional nausea, loss of appetite, lower back pain, and significant pressure-like pain along my spine.

In desperation, I sought local medical care, where the doctor prescribed antibiotics for both cystitis and urethritis for one week, but there was no improvement.
Urinalysis indicated normal urine, with no sexually transmitted infections or white blood cells present, leading the doctor to rule out any urinary tract-related conditions and suggest that my symptoms might be psychosomatic.
They did not prescribe any medication.
Regardless of how it was explained, I genuinely do not feel that I am under psychological stress; I was quite happy almost every day before falling ill.
I know I am truly unwell, but the doctor seemed to give up on me and allowed me to leave the hospital without further assistance.
Several years ago, I had a history of nephritis in Taiwan, but I only remember severe vomiting, elevated white blood cell counts, receiving IV fluids, and medication; I do not recall the details well.
Currently, I have not experienced any fever, elevated body temperature, urinary pain, or hematuria.
I wonder if my current condition is related to my medical history.
I have been relying on traditional Chinese medicine for two weeks now, and while my lower back pain and nausea have slightly improved and my appetite has increased, the frequent urination persists.

I generally prefer Western medicine, but I am currently in Australia, and due to language barriers, I feel helpless in seeking help for my suffering.
I hope you can provide guidance and assistance.
Thank you.

Niming, 20~29 year old female. Ask Date: 2012/09/08

Dr. Lin Hexing reply Urology

Hello: Based on your symptoms and normal urine test results, it appears to be a case of overactive bladder, a modern civilization ailment.
In addition to adjusting your lifestyle, medication can also lead to gradual improvement.
Regarding lifestyle adjustments, including hydration habits, it is recommended that you drink about 160 cc of water every hour throughout the day, rather than consuming large amounts at once.
Additionally, avoid beverages that can irritate the bladder, such as alcohol, coffee, and tea.
Furthermore, try to relax, as increased stress can lead to more frequent urination.
For medication, please consult a specialist in urology for further assistance.
Wishing you peace and happiness.

Reply Date: 2012/09/08

More Info

Persistent urinary frequency can be a distressing condition, and understanding its underlying causes is essential for effective management. Based on your description, it appears that you are experiencing a range of symptoms, including frequent urination, residual urine sensation, nocturia (waking up at night to urinate), and associated discomfort in the lower back and abdomen. Given your medical history of kidney issues and the recent onset of these symptoms, it is crucial to explore various potential causes and treatment options.

Possible Causes of Your Symptoms
1. Overactive Bladder (OAB): This condition is characterized by a sudden urge to urinate, often accompanied by increased frequency and nocturia. It can occur without any underlying infection or anatomical abnormalities. The sensation of urgency and the inability to hold urine can significantly impact quality of life.

2. Urinary Tract Infection (UTI): Although your urine tests have come back normal, it is important to note that some UTIs can present with atypical symptoms or may not show significant white blood cells in the urine. A culture test could help identify any underlying infection that might not be evident in a standard urinalysis.

3. Interstitial Cystitis (IC): This is a chronic condition that causes bladder pressure, bladder pain, and sometimes pelvic pain. Symptoms can mimic those of a UTI, but without the presence of infection. It often requires a different approach to treatment.

4. Psychosomatic Factors: While you mentioned not experiencing psychological stress, it is worth considering that physical symptoms can sometimes arise from psychological factors. Stress and anxiety can exacerbate urinary symptoms, leading to a cycle of discomfort.

5. Kidney Issues: Given your history of kidney inflammation, it is essential to rule out any residual effects or complications from that condition. Chronic kidney disease or other renal issues could potentially contribute to your symptoms.

6. Prostatitis: In males, inflammation of the prostate can lead to urinary frequency and discomfort. Even if you do not have a prostate, similar conditions can occur in the pelvic region.

Recommended Actions
1. Follow-Up with a Urologist: Since your symptoms have persisted despite initial treatment, a follow-up with a urologist is advisable. They may recommend further diagnostic tests, such as a cystoscopy, to visualize the bladder and rule out conditions like IC or bladder stones.

2. Keep a Bladder Diary: Documenting your fluid intake, urinary frequency, and any associated symptoms can provide valuable information for your healthcare provider. This can help identify patterns and triggers related to your urinary frequency.

3. Consider Physical Therapy: Pelvic floor physical therapy can be beneficial for individuals with urinary frequency and discomfort. A specialized therapist can help address any muscular issues contributing to your symptoms.

4. Explore Medication Options: If overactive bladder is confirmed, medications such as anticholinergics or beta-3 agonists may be prescribed to help manage symptoms. Discussing these options with a urologist would be beneficial.

5. Integrate Holistic Approaches: Since you are currently exploring traditional Chinese medicine, consider integrating this with conventional treatments. Acupuncture and herbal remedies may provide additional relief, but ensure that any treatments do not interfere with prescribed medications.

6. Stay Hydrated but Manage Intake: While it is important to stay hydrated, monitoring your fluid intake and timing can help manage symptoms. Avoiding diuretics like caffeine and alcohol may also reduce urinary frequency.

Conclusion
Your symptoms warrant a thorough investigation to determine the underlying cause. It is essential to communicate openly with your healthcare providers about your concerns and the impact these symptoms have on your life. Persistent urinary frequency can often be managed effectively with the right combination of medical and supportive therapies. Don't hesitate to seek a second opinion if you feel your concerns are not being addressed adequately. Your health and well-being are paramount, and you deserve comprehensive care.

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