Frequent Urination : Causes, Symptoms, Diagnosis & Treatment

• General Information
• Why Does Frequent Urination Occur?
• Physiological Causes
• Infectious Cystitis
• Noninfectious Cystitis
• Change In Bladder Volume
• Diseases Of The Urethra
• Sti
• Kidney Disease
• Neurological Disorders
• Andrological Diseases
• Gynecological Pathologies
• Endocrine Disorders
• Other Reasons
• Diagnostics
• Treatment
• Conservative Therapy
• Surgery

Frequent urination (pollakiuria) is observed with cystitis, a decrease in the volume of the detrusor, urethritis, STIs, kidney diseases, and some andrological, gynecological and endocrine pathologies. Sometimes it has a psychogenic nature. The cause of the symptom is established based on the data of the survey, physical examination, the results of laboratory and hardware techniques. Treatment includes the appointment of antibiotics, NSAIDs, hormones and other drugs, non-drug methods, and surgical interventions.

general information

Normally, an adult produces 1.5-2 liters of urine per day. The frequency of mictions in most cases ranges from 3 to 7 times, during one urination, 200-30 ml of urine leaves. They say about pollakiuria, if the patient visits the toilet more than 1 time, while the portions of urine, as a rule, decrease. In children, urination is more frequent: in newborns from 12 to 16 times, up to 3 years - about 1 time, from 3 to 9 years - 6-8 times.

Why does frequent urination occur?

Physiological causes

In the absence of provoking diseases, the cause of short-term pollakiuria is:

• Plentiful drink, features of a diet. Frequent urination follows the use of large amounts of fluid. Other possible provoking factors include the intake of diuretic drinks (coffee), the inclusion of watermelons, cucumbers, and melons in the diet.
• Pregnancy period. Increasing, the uterus presses on the bladder, and in the later stages "lies" on it, which causes a feeling of detrusor overflow and the appearance of urges even with a slight filling of the organ.
• External influences. Due to changes in metabolism and the tone of the renal vessels, micturition becomes more frequent during hypothermia, being in stressful situations.

Infectious cystitis

The most common cause of pollakiuria is nonspecific infectious acute cystitis and chronic inflammation of the bladder during periods of exacerbations. Mictions are painful, with burning and cutting at the final stage. Pain over the womb is determined, sometimes cloudy urine, a slight increase in body temperature. Taking into account the gender and characteristics of the hormonal status, the following variants of the disease are distinguished:

• Among women. The pathology is widespread, which is explained by the wide and short urethra, the ease of penetration of infectious agents from the vulva, vagina and rectum.
• In pregnant women. Hypothermia and general acute infections act as a provoking factor. Pollakiuria is combined with pain and imperative urges. In the postpartum period, urinary retention is often observed.
• With a climax. The number of mictions sometimes reaches 3 per day. There are constant pains in the lower abdomen. A chronic course with periodic relapses is revealed.
• In men. It is rare, provoked by diseases of the male genital organs (often infectious and inflammatory) and urological pathologies, accompanied by stagnation of urine. Along with frequent urination, hematuria, nocturia, stranguria are observed.

Specific tuberculous cystitis occurs when the pathogen spreads with urine in patients with kidney tuberculosis. Characterized by weakness, weight loss, stranguria, urgent urges, pain above the pubis.

Noninfectious cystitis

Interstitial cystitis is typically chronic. Initially, the symptoms are mild. As the morphological changes in the organ worsen, dysuric disorders increase: pollakiuria, nocturia, incontinence occurs. Radiation cystitis develops during or after the end of radiation therapy. In acute inflammation, the symptoms resemble ordinary cystitis. In the chronic form, there is a persistent increase in urination, incontinence, imperative urges.

Pollakiuria

Change in bladder volume

A wrinkled bladder (SMP) develops as a result of tuberculosis, interstitial and chronic radiation cystitis, and some other pathologies. The number of urination is up to 2 or more times a day. Pollakiuria is complemented by nocturia, urgency incontinence. One of the causes of SMP is long-term current paracystitis.

Frequent urination with paracystitis occurs at the initial stage, during the formation of an abscess, is complemented by intense pain, intoxication syndrome. Then the abscess breaks, a large amount of pus is released from the urethra, the condition returns to normal. In chronic course, there is a replacement of perivesical tissue with fibrous tissue with the formation of SMP and the re-development of pollakiuria.

In a ureterocele, the lower portion of the ureter expands and bulges into the bladder cavity. With large hernias, the volume of the detrusor decreases, which causes a rapid accumulation of urine in the remaining space. Urine is excreted frequently, in small portions. With the blockade of the second ureter, the formation of acute hydronephrosis is possible, with the descent of a hernia into the urethra in women, the occurrence of complete urinary retention.

Diseases of the urethra

Acute nonspecific bacterial urethritis is manifested by burning, itching, pain during micturition, the appearance of mucopurulent or purulent discharge from the urethra. The general condition is not broken. Pollakiuria, as a rule, is insignificant, due to unpleasant sensations in the urethra. Urethral diverticula are often asymptomatic for a long time. With the development of complications, there are difficulties, frequent urination, dysuria, incontinence, pain in the groin.

STI

The appearance of a symptom in sexually transmitted infections is associated with the development of specific urethritis. Pollakiuria is observed in mycoplasmosis in men. Decreased libido and erectile dysfunction are combined with pollakiuria, nocturia, cramps, pain, swelling, hyperemia. Gonorrhea manifests suddenly, is manifested by pain, burning, creamy purulent discharge. With the defeat of the back of the urethra in men, significant hyperthermia is determined. Frequent urination is sometimes detected with trichomoniasis, chlamydia, candidiasis in men. It is expressed indistinctly.

kidney disease

Pollakiuria accompanies the following renal pathologies:

• Pyelonephritis. In the acute form, there is no symptom. The chronic course is characterized by anorexia, cephalalgia, and weakness. Lower back pain is possible.
• Glomerulonephritis. In patients with an acute process, the amount of urine first decreases, then increases. At the second stage, frequent urination is detected. Other signs are swelling of the face, increased blood pressure.
• Urolithiasis disease. Pollakiuria becomes one of the manifestations of renal colic. Extremely intense pain in the lumbar region, anxiety, nausea, vomiting are revealed. With further advancement of the stone, blockage of the urinary tract is possible. Sometimes reflex anuria develops.
• Sand in the kidneys. As in the previous case, the symptom appears when the microcalculi move. Dysuria and frequent urges are complemented by a feeling of incomplete emptying of the detrusor, pain in the lumbar region, radiating to the stomach or inguinal zone.

Neurological disorders

The development of pollakiuria is typical of an overactive bladder. Pathology accompanies multiple sclerosis, some types of polyneuropathy. There is nocturia with or without urgency and urge incontinence. In patients with overactive neurogenic bladder, frequent urination is accompanied by incontinence and autonomic disorders. Etiofactors are spinal cord injuries, circulatory disorders, encephalitis, strokes, malformations of the brain and spinal cord.

Andrological diseases

Most often, the symptom is found in diseases of the prostate gland. The reason is a decrease in capacity and secondary changes in the bladder. The prostate compresses the urethra, therefore, pathologies of this group are characterized by difficulties at the beginning of micturition, a weak stream. Frequent urination is observed with prostatitis, prostate adenoma, prostate cancer.

In patients operated on for adenoma or cancer, sclerosis of the bladder neck can act as an etiological factor in pollakiuria. The lethargy of the jet is complemented by a feeling of incomplete emptying, the symptom joins with the development of secondary inflammation. With hypertrophy of the seed tubercle, the jet is weak, intermittent. Requires straining. Premature ejaculation, pain during erection are possible.

Gynecological pathologies

Increased urination is found in the following diseases of the female genital organs:

• Pathologies of the uterus: fibroids , malignant tumors, prolapse, serozometer.
• Ovarian diseases: teratoma, dermoid cyst, neoplasms.
• Problems during menstruation: algomenorrhea, dysmenorrhea in adolescents.

The symptom often accompanies endometriosis, especially in the presence of pathological foci in the bladder zone and adjacent areas. Pollakiuria is a common problem in women suffering from weakness of the pelvic floor muscles. May be accompanied by stress or urgency incontinence.

endocrine disorders

The most obvious sign of diabetes is constant thirst. A large amount of fluid you drink causes polyuria and, as a result, frequent urination. The symptom is more pronounced in type 1 diabetes. In patients with type 2 diabetes, drowsiness, itching, blurred vision, and skin infections come to the fore. Pollakiuria is also observed in Wolfram's syndrome, a hereditary pathology, one of the manifestations of which is diabetes mellitus.

In addition, the violation is detected in steroid diabetes mellitus. In people with diabetes insipidus, the amount of daily urine reaches 1 or more liters. Mictions are frequent, in large portions. Urine is colorless, "diluted". Antidiuretic hormone deficiency is also seen in hypopituitarism, the clinical presentation of which includes diabetes insipidus, hypogonadism, hypothyroidism, and hypocorticism.

Other reasons

Polyuria and pollakiuria develop against the background of alimentary dystrophy caused by voluntary or forced starvation. The symptom is found in vegetative and mental disorders, including:

• neurasthenia;
• generalized anxiety disorder;
• panic attacks;
• vegetative-vascular dystonia.

Tests for pollakiuria

Diagnostics

Diagnostic measures are carried out by a urologist. According to indications, an andrologist, gynecologist, endocrinologist and other specialists are involved in the examination. If a mental disorder is suspected, patients are referred for a consultation with a psychotherapist or psychiatrist. As part of the conversation, the specialist determines the time of occurrence and the severity of frequent urination, the presence of other manifestations that indicate the nature of the disease. Patients are asked to complete a special diary.

During a general examination, the doctor identifies areas of pain, conducts special tests (for example, checks Pasternatsky's symptom), assesses the general condition of the body, nutritional level, etc. Women are shown an examination on a chair, men with suspected andrological pathology - a digital examination of the prostate. With neurogenic disorders, a neurological examination is performed. The plan of additional examinations includes such procedures as:

• Ultrasonography. When conducting an ultrasound of the bladder, corresponding changes in the wall of the organ are detected. Ultrasound of the prostate can confirm the presence of inflammation and masses. According to the ultrasound of the small pelvis in women, they make up a comprehensive view of the state of the reproductive system. On ultrasound of the kidneys, calculi, structural disorders, and inflammatory processes are detected.
• Beam techniques. In diseases of the kidneys, an overview or excretory urography is indicated. In case of violations of renal functions, a contrast study is carried out with caution. The pictures show an increase or deformation of the kidney, calculi, tumors. One of the most revealing methods of examination for urolithiasis is CT of the kidneys. For diverticula, retrograde urography is performed.
• Endoscopic methods. Cystoscopy allows you to determine the nature of inflammation in cystitis, confirm cervical sclerosis, wrinkling or the presence of an ureterocele, and exclude tumor processes. Ureteroscopy reveals diverticula. Patients with gynecological diseases sometimes require hysterosalpingoscopy. During endoscopic examinations, a biopsy can be taken.
• Laboratory tests. Urinalysis may reveal leukocyturia, bacteriuria, proteinuria. To determine the nature of the microflora, microscopy of smears and discharge is performed, sowing on nutrient media. STIs are confirmed by ELISA, PCR. In diseases of the prostate, the level of PSA is evaluated. In diabetes, the levels of glucose, insulin and C-peptide are examined. In diabetes insipidus, an ADH test is done.

Treatment

Conservative therapy

Therapeutic tactics is determined by the cause of the development of pollakiuria:

• cystitis. Antibiotic therapy is carried out, uroseptics, NSAIDs, intravesical instillations, physiotherapy are used. Patients with interstitial cystitis are prescribed antihistamines, synthetic mucopolysaccharides, tricyclic antidepressants.
• Urethritis. Antibiotics are used for nonspecific urethritis. In specific forms, antimicrobial drugs are selected taking into account the sensitivity of the pathogen. Antifungal and antitrichomonal agents may be required, sometimes a combination of several medications or a combination of antibiotics and hormones is effective.
• Diseases of the kidneys. Antibiotic therapy is supplemented with anti-inflammatory drugs, measures to correct immunity. Eliminate the causes of violation of the outflow of urine. With glomerulonephritis, symptomatic treatment is carried out, aimed at reducing edema and normalizing blood pressure.
• Andrological pathologies. It is possible to use antibacterial agents, analgesics, antispasmodics, NSAIDs, adrenoblockers, hormones, antioxidants. In some cases, local treatment is effective (urethral instillations, thermotherapy), physiotherapy. For malignant tumors, radiation therapy and chemotherapy are indicated.
• Gynecological diseases. Often, correction of the physical activity regimen, restriction of weight lifting, and the implementation of special exercise therapy complexes are required. Some women need hormone replacement therapy. Sometimes the use of pessaries is indicated.
• Endocrine diseases. Patients with diabetes are recommended diet therapy, insulin therapy, or taking hypoglycemic drugs. In diabetes insipidus, synthetic analogs of ADH or drugs that stimulate the production of antidiuretic hormone are used. Carry out correction of water-salt balance.

Surgery

Taking into account the etiology of frequent urination, such surgical interventions are performed as:

• Wrinkling of the detrusor: intestinal plastic of the bladder, augmentation cystoplasty.
• Urethral diverticulum: marsupialization, transurethral or transvaginal diverticulectomy.
• Urolithiasis: ureterolithoextraction, ureterolithotomy, nephrolithotomy, percutaneous or extracorporeal lithotripsy.
• Andrological diseases: adenomectomy, transurethral resection, laser vaporization, prostatectomy.
• Gynecological pathologies: oophorectomy, removal of appendages, hysteroresectoscopy, laparoscopic or laparotomic removal of fibroids, excision of endometriosis foci, hysterectomy, sacrovaginopexy.