Definition

Frequent urination means needing to urinate more often than usual. Urgent urination is a sudden, strong need to urinate. This causes a discomfort in your bladder. Urgent urination makes it difficult to delay using the toilet.

A frequent need to urinate at night is called nocturia. Most people can sleep for 6 to 8 hours without having to urinate.

Alternative Names

Urgent urination; Urinary frequency or urgency; Urgency-frequency syndrome; Overactive bladder (OAB) syndrome; Urge syndrome

Causes

Common causes of these symptoms are:

• Urinary tract infection (UTI)
• Enlarged prostate in middle-aged and older men
• Swelling and infection of the urethra
• Vaginitis (swelling or discharge of the vulva and vagina)
• Nerve related problems
• Caffeine intake

Less common causes include:

• Alcohol use
• Anxiety
• Bladder cancer (not common)
• Spine problems
• Diabetes that is not well controlled
• Pregnancy
• Interstitial cystitis
• Medicines such as water pills (diuretics)
• Overactive bladder syndrome
• Radiation therapy to the pelvis, which is used to treat certain cancers
• Stroke and other brain or nervous system diseases
• Tumor or growth in the pelvis

Home Care

Follow the advice of your health care provider to treat the cause of the problem.

It may help to write down the times when you urinate and the amount of urine you produce. Bring this record to your visit with the provider. This is called a voiding diary.

In some cases, you may have problems controlling urine (incontinence) for a period of time. You may need to take steps to protect your clothing and bedding.

For nighttime urination, avoid drinking too much fluid before going to bed. Cut down on the amount of liquids you drink that contain alcohol or caffeine.

When to Contact a Medical Professional

Contact your provider right away if:

• You have fever, back or side pain, vomiting, or shaking chills
• You have increased thirst or appetite, fatigue, or sudden weight loss

Also contact your provider if:

• You have urinary frequency or urgency, but you are not pregnant and you are not drinking large amounts of fluid.
• You have incontinence or you have changed your lifestyle because of your symptoms.
• You have bloody or cloudy urine.
• There is a discharge from the penis or vagina.

What to Expect at Your Office Visit

Your provider will take a medical history and do a physical exam.

Tests that may be done include:

• Urinalysis
• Urine culture
• Cystometry or urodynamic testing (a measurement of the pressure within the bladder)
• Cystoscopy
• Nervous system tests (for some urgency problems)
• Ultrasound (such as an abdominal ultrasound or a pelvic ultrasound)

Treatment depends on the cause of the urgency and frequency. You may need to take antibiotics and medicine to ease your discomfort.

References

Conway B, Phelan PJ, Stewart GD. Nephrology and urology. In: Penman ID, Ralston SH, Strachan MWJ, Hobson RP, eds. Davidson's Principles and Practice of Medicine. 24th ed. Philadelphia, PA: Elsevier; 2023:chap 18.

Rane A, Kulkarni M, Iyer J. Prolapse and disorders of the urinary tract. In: Symonds I, Arulkumaran S, eds. Essential Obstetrics and Gynaecology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 21.

Reynolds WS, Cohn JA. Overactive bladder. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 117.