Urinary Frequency

Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use, so you may find the language more technical than the condition leaflets.

See also: Pregnancy and Diabetes written for patients

The basic causes of urinary frequency can be divided into three groups:

  • Polyuria when too much urine is being produced.
  • Instability of the detrusor mechanism.
  • Inability of the bladder to stretch.

However, urinary frequency strictly speaking occurs when there is an increased need to urinate more often without a concomitant increase in the volume of urine.

The prevalence increases with age and is more common in women. In the elderly it is very common in both sexes. Risk factors include hypertension, obesity and smoking.[2]

Symptoms

  • Other urinary symptoms:
    • Dysuria.
    • Urgency.
    • Haematuria.
    • Nocturia.
    • Hesitancy.
    • Dribbling.
    • Abdominal pain.
    • Urinary incontinence (may suggest detrusor instability or may relate to inability to get to the toilet on time; also common in pregnancy).[3]
  • Also question about systemic symptoms - eg, weight loss, fever, etc.

Signs

  • May be normal.
  • Look for a distended bladder.
  • In women vaginal examination may be appropriate.
  • In men digital rectal examination should be performed.

Definite

  • Midstream urine for dipstick, microscopy, culture and sensitivities and pregnancy testing as appropriate.

Blood tests

  • FBC, renal function, liver function, glucose, calcium.
  • Prostate specific antigen (PSA) in men.

Imaging

  • This will depend on the clinical suspicion.
  • Bladder, renal and ureteric ultrasound.
  • CT scan or intravenous urography (IVU) looking for ureteric stones.
  • Bladder flow studies and cytometry.
  • Cystoscopy.

Other

A screen for sexually transmitted infections (STIs) may be appropriate:

  • Urinary tract symptoms may also be associated with STIs.
  • One study of 264 women presenting to an emergency department with UTI-type symptoms reported 100 (57%) as having been treated without performing a urine culture. Of these, sixty (23%) had one or more positive STI tests.[4]

This depends on the underlying cause and may range from a course of antibiotics to removal of a bladder neoplasm.

This is a clinical syndrome with one or more of the following:

  • Urgency
  • Frequency
  • Nocturia
  • Incontinence

Patients have an immediate need to empty the bladder, which comes on suddenly.

Current management options include bladder training, anticholinergic drugs, intravesical botulinum toxin injections, intermittent self-catheterisation and sacral or posterior tibial nerve stimulation.[5, 6]Current research is focusing on modifications of existing drugs and a re-evaluation of old treatments.[7]

See also separate Overactive Bladder article.

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Further reading & references

  1. Link CL, Steers WD, Kusek JW, et al; The association of adiposity and overactive bladder appears to differ by gender: results from the Boston Area Community Health survey. J Urol. 2011 Mar 185(3):955-63. doi: 10.1016/j.juro.2010.10.048. Epub 2011 Jan 19.
  2. Hsieh CH, Chang WC, Hsu MI, et al; Risk factors of urinary frequency among women aged 60 and older in Taiwan. Taiwan J Obstet Gynecol. 2010 Sep 49(3):260-5. doi: 10.1016/S1028-4559(10)60058-7.
  3. Wesnes SL, Rortveit G, Bo K, et al; Urinary incontinence during pregnancy. Obstet Gynecol. 2007 Apr 109(4):922
  4. Tomas ME, Getman D, Donskey CJ, et al; Overdiagnosis of Urinary Tract Infection and Underdiagnosis of Sexually Transmitted Infection in Adult Women Presenting to an Emergency Department. J Clin Microbiol. 2015 Aug 53(8):2686-92. doi: 10.1128/JCM.00670-15. Epub 2015 Jun 10.
  5. Madhuvrata P, Cody JD, Ellis G, et al; Which anticholinergic drug for overactive bladder symptoms in adults. Cochrane Database Syst Rev. 2012 Jan 18 1:CD005429. doi: 10.1002/14651858.CD005429.pub2.
  6. Martinson M, Macdiarmid S, Black E; Cost of neuromodulation therapies for overactive bladder: percutaneous tibial nerve stimulation versus sacral nerve stimulation. J Urol. 2013 Jan 189(1):210-6. doi: 10.1016/j.juro.2012.08.085. Epub 2012 Nov 20.
  7. Andersson KE; Drug therapy of overactive bladder--what is coming next? Korean J Urol. 2015 Oct 56(10):673-9. doi: 10.4111/kju.2015.56.10.673. Epub 2015 Oct 2.
Original Author:
Dr Gurvinder Rull
Current Version:
Dr Laurence Knott
Peer Reviewer:
Dr Helen Huins
Document ID:
499 (v5)
Last Checked:
03 July 2016
Next Review:
02 July 2021

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.