What Is Urinary Urgency and Frequency?
Do you feel like you need to pee all the time, or that you have a ‘small bladder’? Do you sometimes get sudden, strong urges to urinate and have trouble making it to the bathroom in time? These are common symptoms of urinary frequency and urgency, and they commonly affect both men and women.
When considering frequent urination, you’re probably wondering what is considered “more than usual.” In most cases, it is normal to urinate every 2 to 4 hours during the day, and up to one time at night. More frequently than that qualifies as urinary frequency, and it may even interfere with your daily life.
Urinary urgency is characterized by a sudden and urgent need to urinate. Pain or discomfort in the bladder may accompany urinary urgency symptoms. Many people with urgency find they sometimes don’t make it to the restroom in time when a strong urge strikes, which is called urge incontinence. Urgency is often associated with triggers, for example running water, pulling into the driveway or putting your key in the door, standing up from a desk at work, and even unbuttoning your pants in the bathroom!
It is common for urinary urgency, frequency, and urge incontinence symptoms to occur together. Often people with one or more of these issue experience anxiety when there is no bathroom nearby. Many begin to limit their activities away from home as a result of this worry.
What Causes Urinary Urgency and Frequency?
There are many potential causes of urinary urgency and frequency symptoms. Certainly a urinary tract infection can cause such symptoms. If your symptoms are new or becoming severe, it is a good idea to see your primary care doctor or urologist to rule this out.
However, tension or irritability of the pelvic muscles can often cause or contribute to urgency and frequency. When the pelvic muscles are tight or in spasm, they can squeeze the urethra and the base of the bladder and irritate them. This leads to the urge to urinate too soon or gives off an urge that is too strong.
In addition to muscle tension, the messaging between the brain and the bladder can become “confused” in someone experiencing urgency and/or frequency. When this occurs, the brain over-reacts to the quantity of fluid in the bladder and causes the symptoms mentioned above. The brain can also over-ride our attempt to squeeze our muscles to keep the urine in while rushing to the bathroom, which may result in the the loss of a large quantity of urine. Pelvic health therapists are experts and helping you re-train this connection to resolve urgency, frequency, and urge incontinence.
Underlying constipation can also be a cause of urgency and frequency. When there is stool sitting in the rectum, it puts pressure on the bladder that can also contribute to urgency or frequency. Other factors that may increase the likelihood and severity of urgency and frequency include:
- Fluid intake – either too much or too little
- Hormonal changes
- Drinking caffeinated or alcoholic beverages
- Diabetes
- Pregnancy
- Prostate enlargement or infection
- Anxiety
- Urinary tract infection
- Medication side-effects
Individuals who have recently undergone surgery to their urinary tract or the surrounding area may also experience frequency and urgency symptoms and can be helped by pelvic therapy.
How Are Urinary Urgency And Frequency Issues Diagnosed?
There are several ways urinary disorders may be diagnosed. In pelvic therapy, we take a thorough history from you that includes your bladder and bowel habits as well as what you eat and drink each day. We also review any testing that has been done by other providers. In addition, our physical exam allows us to determine whether you have pelvic muscle tension that may be causing or contributing to your urgency or frequency.
Again, if these symptoms are new it is wise to see a PCP or urologist to rule out an underlying infection prior to beginning pelvic therapy. In some cases, your specialist may decide that more detailed testing is necessary. Cystoscopies (a look inside the bladder with a tiny camera), ultrasounds of the kidneys and bladder, and urodynamic tests (observing bladder pressure during filling and urinating) are commonly used procedures if a urologist determines more extensive testing is necessary.
When To Seek Treatment
The best time to seek treatment for issues with frequent and urgent urination is as soon as you start noticing them. Urgency and frequency are often resolved more quickly when we address them early. That said, it is never too late! Each and every day in pelvic therapy, we help people who have had these annoying issues for decades!
If your symptoms go beyond urgency, frequency, and urge incontinence and are more serious, please do immediately reach out to your doctor.
Symptoms to watch out for include:
- Blood in urine
- Pain in abdomen or sides
- Urine that is unusually cloudy or odorous
- Discharge from penis or vagina
Treatment Options
While urgency and frequency may not be life-threatening, they can cause a great deal of discomfort and inconvenience. Once an infection is ruled out, pelvic floor therapy can often resolve these concerns. This treatment may include treatment to release tight pelvic muscles, bladder retraining, strategies to gain control over strong urges, and treatment for constipation. Urgency and frequency can worsen to the point that they significantly affect your quality of life, so do not delay! Schedule yourself an in-person or Telehealth pelvic therapy appointment.
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