Frequent Urination - Causes And Treatments

Urinary System Diagram

1. Urinary system:
2. Kidney, 3. Renal pelvis, 4. Ureter, 5. Urinary bladder, 6. Urethra. 7. Adrenal gland
Vessels:
8. Renal artery & vein, 9. Inferior vena cava, 10. Abdominal aorta, 11. Common iliac artery & vein
With transparency:
12. Liver, 13. Large intestine, 14. Pelvis

Frequent urination, where you feel an urge to pass urine more often than usual, is not just a a nuisance and a cause of poor sleep, it can be a symptom of an underlying medical condition. Polyuria is a medical term that refers to the excessive passing of urine (frequent urination).

Unfortunately many people soldier on, perhaps accepting it as something they have to put up with, or they don't think it is worth bothering the doctor about, or maybe they are scared it might signify something serious.

But often, when they seek diagnosis and treatment, patients find the cause is not serious or harmful, and it is possible to return to normal urinary habits.

For instance, frequent urination can result from drinking too many fluids, particularly those containing caffeine or alcohol. Pregnant women often have the condition, due to the enlarged uterus pressing on the bladder.

However, should it be the case that frequent urination is a symptom of something more serious, then there is even more reason to seek medical attention, because the sooner it is diagnosed and treated, the greater the chance of successful treatment.

This article first considers the nature of urination, and then some of the symptoms, causes, and treatments of frequent urination.

Urine and Urination

Urine is a waste product made in the kidneys. The kidneys spurt urine into the ureters which then pass it into the bladder, where it collects ready to be expelled from the body via the urethra.

Normal urine is a clear, transparent, amber-colored fluid made of urea, uric acid, and water. Some diseases cause other substances to appear in urine, such as sugar (diabetes), albumin (kidney disease), and bile pigments (jaundice).

The average person probably excretes about 5 to 8 cups or 1 to 1.8 litres of urine every 24 hours.

Urination or micturition is the process of expelling urine from the body. The process is complex and involves muscles of the bladder and sphincter mechanism, controlled by various nerve centers in the central and peripheral nervous systems.

For example, the bladder itself is mostly an intricate mesh of interlaced bundles of smooth muscle, known as the detrusor, that relaxes to fill the bladder, while the sphincter mechanism keeps the exit tightly shut and comprises slow twitch muscle fibers in the walls of the urethra, and some muscles that are also part of the pelvic floor.

During urination, the detrusor contracts to squeeze urine out of the bladder, and the sphincter mechanism relaxes, allowing smooth outflow of urine.

In infants and very young children, the process of urination is involuntary, and then gradually, by around 3 to 5 years of age, they have learned to control it and make it voluntary.

The nerve circuitry that controls urination is highly distributed and far from simple, involving far-reaching pathways on several levels. These are in the brain, the spinal cord, and the peripheral nervous system, and interact with many chemical messengers or neurotransmitters.

Research using brain imaging has revealed that in humans, parts of the brain normally associated with thinking and planning of complex behaviours and expression of personality, have strong and direct connections with circuits involved in urination, such as those that relax the sphincter and empty the bladder.

Frequent Urination and Associated Symptoms

Frequent urination is where you pass urine more often than usual. This can sometimes occur with urgent urination: a sudden, compelling urge to urinate, along with discomfort in the bladder.

Most people can sleep for 6 to 8 hours without having to urinate, but many have to get up in the night to relieve themselves. This frequent need to urinate at night is called nocturia, and is common in both men and women. By disturbing sleep, nocturia can significantly affect quality of life.

It is important to assess the underlying cause of nocturia, because chronic conditions, such as diabetes, can present in this way.

Frequent urination is not the same as urinary incontinence, which is where there is no voluntary control of bladder function, reminiscent of the infant's involuntary reflex. However, urinary incontinence can be a cause of frequent urination, and/or the two can occur together.

When doctors assess urinary symptoms, they try to distinguish among several possibilities, such as nocturia, daytime frequent urination, urinary incontinence, obstructive symptom (such as poor, intermittent stream or terminal dribble), and irritative symptoms (such as urgency, burning sensation).

There are also other considerations, such as when is the symptom not something to worry about? For instance, in men it is so common to have a little "leakage" at the end of the stream (the post-micturition dribble), that it does not count as an abnormality. Also, many women leak a little urine on coughing.

So one of the ways to decide if a seemingly harmless urinary symptom is an issue, is to establish the extent to which it impacts quality of life.

If urinary frequency is affecting your quality of life, or you also have other unexplained symptoms such as back or side pain, vomiting, fever, chills, fatigue, bloody or cloudy urine, or discharge from the vagina or penis, or an increase in appetite or thirst, then it is important to seek medical attention promptly.

For instance, one cause of frequent urination is kidney infection, and this requires prompt attention. If not treated, a kidney infection can permanently damage the kidneys, or the bacteria can infect the bloodstream and become life-threatening.

Causes of Frequent Urination

Urination is a complex process involving different muscle groups and types, and an intricate nerve network located in the brain and spine, and in and around the bladder. It is no wonder therefore that frequent urination can be a symptom of so many different diseases, conditions and disorders, both physiological and psychological.

The main thing to bear in mind is that if frequent urination is unexplained and persistent, then it could be a symptom of something serious. Some drugs, such as diuretics, can also produce this symptom.

Drinking too much fluid before bedtime, especially if it contains caffeine or alcohol, can cause frequent urination at nighttime.

Or frequent urination could simply be a habit, in which case it may still be advisable to eliminate other potential concerns.

The most common causes of frequent urination are diabetes, pregnancy and prostate problems.

Other causes of frequent urination include:

• Anxiety,
• Medication, for example diuretics,
• Stroke, or other brain or nervous system condition,
• Infection of the prostate gland (prostatitis),
• Enlarged prostate,
• Kidney infection,
• Tumor or mass in the pelvic area,
• Interstitial cystitis (inflammation of the bladder wall),
• Overactive bladder syndrome (unexplained, uncontrolled bladder contractions),
• Cancer of the bladder,
• Dysfunction of the bladder,
• Bladder stones,
• Urinary incontinence,
• Abnormal opening (fistula) in the urinary tract,
• Radiation of the pelvis, eg to treat cancer, and
• Diverticulitis (inflammation of diverticulosis, small, bulging sacs or pouches that can develop on the inner lining of the large intestine).