Question Title: Constant urges to urinate

Posted by Darrell on June 19, 1999 at 18:22:38

I am a 30 year old otherwise healthy Englishman and have most recently found the urge to urinate constantly. From a (normal/average) 4/5 hours 2 years ago, getting gradually worse up to the point I am now. I have never had any pain or blood in the two years and the stream seems o.k. I recently had analysis, ultra sound and cystoscopy all with a negative result. When this condition first appeared I was not too concerned but it has now encroached on my lifestyle so much that my anxiety must be making it worse. I had epididymitis from 94-96 which responded well to antibiotics but it would seem that any link (EG. prostatitis) which I originally strongly suspected has been dismissed by my urologist following the last procedure.

Any advice/comments would be greatly appreciated.

---

Posted by HFHS M.D.-BE on June 29, 1999 at 10:36:23

---

=

---

Dear Darrell,
With the descriptions that you have given, it seems that since infection/prostatitis has been ruled out, the next possibility may be an unstable or overactive bladder. This condition may be through a neurologic mechanism where the bladder gets signals to contract inappropriately, imparting spasm and thus the sensation of urgency. Some of the possible causes include Parkinson's disease, multiple scleroisis and spinal cord lesions or injuries. Other non-neurologic causes may be: bladder stones, bladder tumor and bladder infection. Interstitial cystitis (IC) is another possible cause which may give symptoms of urinary urgency. IC can affect people of any age, race or sex. It is, however, most commonly found in women. It is due to chronic inflammation of the bladder wall and unfortunately there is no known cure. It differs from common cystitis in that the latter is caused by a bacterial infection which can be treated by antibiotic therapy. It is also important to note that IC is not a psychosomatic disorder nor is it caused by stress. The symptoms include:
-Frequency-Day and/or night urination(up to 60 times a day in severe cases.) In early or very mild cases, frequency is sometimes the only symptom.
-Urgency-The sensation of having to urinate immediately may also be accompanied by pain, pressure or spasms.
Some of these have already been ruled out, through the work-up that you have outlined. Sometimes urinary urgency is a self limiting problem , and the cause may never be known. Regardless, a follow-up with your urologist to have a urodynamics study performed may help delineate some of theses issues. Medications may then be prescribed to alleviate your symptoms.

This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).

Sincerely,
HFHS M.D.-BE
*keyword: urinary urgency

---