Urinary Frequency

ExitCare ImageThe number of times a normal person urinates depends upon how much liquid they take in and how much liquid they are losing. If the temperature is hot and there is high humidity then the person will sweat more and usually breathe a little more frequently. These factors decrease the amount of frequency of urination that would be considered normal.

The amount you drink is easily determined, but the amount of fluid lost is sometimes more difficult to calculate.

Fluid is lost in two ways:

  • Sensible fluid loss is usually measured by the amount of urine that you get rid of. Losses of fluid can also occur with diarrhea.

  • Insensible fluid loss is more difficult to measure. It is caused by evaporation. Insensible loss of fluid occurs through breathing and sweating. It usually ranges from a little less than a quart to a little more than a quart of fluid a day.

In normal temperatures and activity levels the average person may urinate 4 to 7 times in a 24-hour period. Needing to urinate more often than that could indicate a problem. If one urinates 4 to 7 times in 24 hours and has large volumes each time, that could indicate a different problem from one who urinates 4 to 7 times a day and has small volumes. The time of urinating is also an important. Most urinating should be done during the waking hours. Getting up at night to urinate frequently can indicate some problems.

CAUSES

The bladder is the organ in your lower abdomen that holds urine. Like a balloon, it swells some as it fills up. Your nerves sense this and tell you it is time to head for the bathroom. There are a number of reasons that you might feel the need to urinate more often than usual. They include:

  • Urinary tract infection. This is usually associated with other signs such as burning when you urinate.

  • In men, problems with the prostate (a walnut-size gland that is located near the tube that carries urine out of your body). There are two reasons why the prostate can cause an increased frequency of urination:

  • An enlarged prostate that does not let the bladder empty well. If the bladder only half empties when you urinate then it only has half the capacity to fill before you have to urinate again.

  • The nerves in the bladder become more hypersensitive with an increased size of the prostate even if the bladder empties completely.

  • Pregnancy.

  • Obesity. Excess weight is more likely to cause a problem for women more than for men.

  • Bladder stones or other bladder problems.

  • Caffeine.

  • Alcohol.

  • Medications. For example, drugs that help the body get rid of extra fluid (diuretics) increase urine production. Some other medicines must be taken with lots of fluids.

  • Muscle or nerve weakness. This might be the result of a spinal cord injury, a stroke, multiple sclerosis or Parkinson's disease.

  • Long-standing diabetes can decrease the sensation of the bladder. This loss of sensation makes it harder to sense the bladder needs to be emptied. Over a period of years the bladder is stretched out by constant overfilling. This weakens the bladder muscles so that the bladder does not empty well and has less capacity to fill with new urine.

  • Interstitial cystitis (also called painful bladder syndrome). This condition develops because the tissues that line the insider of the bladder are inflamed (inflammation is the body's way of reacting to injury or infection). It causes pain and frequent urination. It occurs in women more often than in men.

DIAGNOSIS

  • To decide what might be causing your urinary frequency, your healthcare provider will probably:

  • Ask about symptoms you have noticed.

  • Ask about your overall health. This will include questions about any medications you are taking.

  • Do a physical examination.

  • Order some tests. These might include:

  • A blood test to check for diabetes or other health issues that could be contributing to the problem.

  • Urine testing. This could measure the flow of urine and the pressure on the bladder.

  • A test of your neurological system (the brain, spinal cord and nerves). This is the system that senses the need to urinate.

  • A bladder test to check whether it is emptying completely when you urinate.

  • Cytoscopy. This test uses a thin tube with a tiny camera on it. It offers a look inside your urethra and bladder to see if there are problems.

  • Imaging tests. You might be given a contrast dye and then asked to urinate. X-rays are taken to see how your bladder is working.

TREATMENT

It is important for you to be evaluated to determine if the amount or frequency that you have is unusual or abnormal. If it is found to be abnormal the cause should be determined and this can usually be found out easily. Depending upon the cause treatment could include medication, stimulation of the nerves, or surgery.

There are not too many things that you can do as an individual to change your urinary frequency. It is important that you balance the amount of fluid intake needed to compensate for your activity and the temperature. Medical problems will be diagnosed and taken care of by your physician. There is no particular bladder training such as Kegel's exercises that you can do to help urinary frequency. This is an exercise this is usually done for people who have leaking of urine when they laugh cough or sneeze.

HOME CARE INSTRUCTIONS

  • Take any medications your healthcare provider prescribed or suggested. Follow the directions carefully.

  • Practice any lifestyle changes that are recommended. These might include:

  • Drinking less fluid or drinking at different times of the day. If you need to urinate often during the night, for example, you may need to stop drinking fluids early in the evening.

  • Cutting down on caffeine or alcohol. They both can make you need to urinate more often than normal. Caffeine is found in coffee, tea and sodas.

  • Losing weight, if that is recommended.

  • Keep a journal or a log. You might be asked to record how much you drink and when and when you feel the need to urinate. This will also help evaluate how well the treatment provided by your physician is working.

SEEK MEDICAL CARE IF:

  • Your need to urinate often gets worse.

  • You feel increased pain or irritation when you urinate.

  • You notice blood in your urine.

  • You have questions about any medications that your healthcare provider recommended.

  • You notice blood, pus or swelling at the site of any test or treatment procedure.

  • You develop a fever of more than 100.5° F (38.1° C).

SEEK IMMEDIATE MEDICAL CARE IF:

You develop a fever of more than 102.0° F (38.9° C).