Frequent Urination: Treatment, Procedure, Cost and Side Effects

Frequent urination is a condition in which a person experiences the urge to urinate more often than he or she normally would. Under normal circumstances, a person passes urine 4 to 8 times a day. But when a person passes urine more than 8 times a day or wakes up multiple times at night to go to the toilet, then it usually indicates the problem of frequent urination.

For people experiencing frequent urination, the urge to pass urine is often sudden and accompanies the feeling of a full bladder. A person may also experience the feeling of losing control over their bladder. Frequent urination can take a toll on your normal day-to-day routine and adversely affect your sleep cycle.

Frequent urination can be a sign of one or more underlying medical condition(s). These conditions include:

• Urinary tract infection (UTI): A urinary tract infection (UTI) is one of the most common causes of frequent urination. The condition occurs when bacteria invade the bladder via the urethra. Women are at a greater risk of UTI than men because they possess shorter urethras which make it easy for bacteria to travel to and cause infection in the urinary tract.
• Overactive bladder (OAB): An overactive bladder (OAB) is a condition that involves involuntary contractions of the bladder due to overactivity in bladder muscles. Causes of OAB include injury, conditions such as multiple sclerosis or stroke, estrogen deficiency (in women), excess weight, etc.
• Diabetes: Frequent urination is usually an indicator of diabetes (both T1D and T2D). Diabetes stimulates the expulsion of excess or unused glucose from the body via urine.
• Pregnancy: During the pregnancy, the size of the uterus increases significantly. This growth of uterus exerts pressure on the bladder. This triggers a frequent urge to urinate.
• Prostate problems: Men can experience frequent urge to pass urine when an enlarged prostate exerts pressure against the urethra. The pressure can restrict the passage of urine and may irritate the walls of the bladder. This triggers the bladder to contract even when it contains low levels of urine.

Besides the aforementioned health conditions, frequent urination can also be a sign of stress or anxiety, high intake of diuretics, stones in bladder or kidney, interstitial cystitis etc. In some cases, it can also indicate sexually transmitted infection (STI), bladder cancer, colon diverticulitis, tumour in the pelvic region etc.

Besides the recurring urge to pass urine, there are certain other symptoms that may accompany frequent urination. Some of those are:

• Poor bladder control
• Pain or discomfort while passing urine
• Lower back pain
• Nocturia (frequent urge to urinate at night)
• Fever
• Nausea
• Presence of blood in the urine
• Increased thirst or appetite
• Discharge from penis or vagina

However, these symptoms generally vary depending on the underlying medical condition.

A number of biological processes are associated with the production and expulsion of urine from the body. Therefore, a number of factors can influence the urge to urinate more frequently. Some of the possible causes of frequent urination are:

• Urinary Tract Infection
• Overactive Bladder Syndrome
• Diabetes
• Stones on kidney or bladder
• Stroke or neurological conditions
• High intake of caffeine or other diuretics
• Interstitial cystitis
• Chronic stress or anxiety

Other possible causes include sexually transmitted infections, tumours in the pelvic region, bladder cancer, or history of radiation or chemotherapy.

Also, there are certain conditions that can cause frequent urination in men and women. Men with an enlarged prostate are at increased risk of experiencing frequent urination as the pressure exerted by the prostate can irritate walls of the urinary bladder and stimulate contractions. This results in a recurring feeling of passing urine. Similarly, pregnancy leads to a growth of uterus in women that often presses against the bladder and triggers the bladder to contract.

Doctors will carry out a detailed study of the patient’s medical history before beginning their actual treatment. It also includes

• Physical examinations of urine samples
• The onset and duration of this disorder
• The pattern of frequent urination
• Overall water or fluid consumption
• Other symptoms of aching, itching etc
• Any ongoing medicines

Frequent urination tests:

Tests include routine and culture of urine samples, ultrasound, for a visual image of the kidneys, CT scan of the abdomen (KUB- Kidney, Uterus and Bladder), cystoscopy, neurological tests to detect any nerve disorder, and other associated examinations.

Treatment of frequent urination will depend on the underlying cause. Doctors (or particularly urologists) will address the root cause prior to beginning the treatment. Every doctor prescribes routine and culture tests of urine samples to determine the cause.

Depending on the condition, possible treatment may include or involve:

• For Diabetes: Medications or treatment to keep blood glucose levels under control
• For Bacterial infection: Medications such as antibiotics and painkillers
• For Overactive bladder/urinary incontinence: Medications that regulate the muscle spasms in the urinary bladder

Treatment may include drugs such as: darifenacin (Enablex), desmopressin acetate (Noctiva), imipramine (Tofranil), mirabegron (Myrbetriq), oxybutynin (Ditropan), etc. Medicines are prescribed for at least two sessions to prevent the recurrence of the disorder.

Antibiotics are used to kill bacteria like E-coli, B-coli that cause infection which results in frequent urination along with other symptoms of pain and itchiness. Otherwise, doctors may recommend a change in the life style and food habit to curb the disorder.

Bladder retaining method can also be a technique for treatment. The drug Botox can be injected into the bladder muscle which causes the bladder to relax, increases its storage capacity, and reduces episodes of leakage.

Treatment for overactive bladder includes doing pelvic exercises, such as Kegels or bladder retraining exercises, to help delay urination, diet modification and monitoring fluid intake. Also, a medication known as an anticholinergic may be used. Apart from these, in cases of severe urinal problems, surgeries are also available depending upon the severity of the disorder.

Treatment of frequent urination with prolonged medicines can cause side effects. For severe cases, when the patient is taking medicine for a very large period, the body may grow resistant to the particular drug and stop responding. Patients may feel nausea, headache, vomiting, loss of appetite, etc.

Prolonged medicines also stunt proper growth and development of the body. Short term medicines do not cause side effects if the individual is not allergic to any particular drug.

After the treatment, doctor's advice should be strictly followed including timely consumption of medicines, maintaining proper food and liquid intake, urinating as necessary etc. A retest of the physical examinations should be done post medicinal course to check upon the disorder and other related infections.Also, after completion of medicines, it is advised to recheck with the doctor to prevent further recurrence of the issue.

The duration of the treatment addresses the underlying root cause of the disorder. Depending on the cause, the time varies. For mild infections and problems, the time needed to cure this urination frequency is not much. However, for complicated situations, it may take upto eight months or even a year to get cured.

The cost required for the treatment of frequent urination is not very money consuming. It mainly includes the consultation fee, varying for different doctors but is usually around Rs.600-Rs 800. The tests prescribed may range in between Rs 1200-Rs 2000. In case of surgical assistance, the price range may increase to Rs 15000-Rs 20000.

The treatment results are usually permanent and prompt. However, in some cases, it may provide temporary relief to the patient without eradicating the cause. Frequent urinaion disorder can be triggered if personal health is not taken care of. If medicines are not taken properly or other instuctions are neglected, then pollakiuria may again reappear with more complications.

The problem of frequent urination can be resolved by addressing the underlying cause. If lifestyle habits such as high intake of fluids, diuretics, caffeinated beverages, alcohol, nicotine and artificial sweeteners are responsible, then monitoring and limiting their intake can provide relief from frequent urination.

However, if a medical condition is responsible for the problem, then you need to consult a physician in order to get the condition diagnosed. After the condition is diagnosed, the physician will prescribe a suitable treatment regimen.

There are certain measures that can be followed to reduce the frequency of urination naturally. These include:

• Bladder Training: This is a treatment that involves training the bladder to retain urine for a longer duration. The training usually spans over 12 weeks. This helps to increase the interval duration between two consecutive trips to the washroom.
• Monitoring intake of fluids: High intake of water and other fluids can increase urine output. This increases the need to urinate frequently. Regulating the intake of fluid throughout the day can reduce the urine output and limit the number of trips to the washroom.
• Kegel Exercises: These are exercises that improve the strength of pelvic muscles and urethra. Kegel exercises are associated with better bladder control and reduced urgency and frequency to pass urine. These are usually prescribed for pregnant women. For best results, these exercises must be done regularly at least 3 times a day for 4 to 8 months.
• Biofeedback: This is a technique that enables a person to improve their control over pelvic muscles. Biofeedback is usually practised alongside kegel exercises.
• Dietary Changes: This involves reducing the consumption of foods and beverages that can irritate the walls of the bladder or those that possess diuretic properties. Some of the foods and beverages that must be avoided are tea, coffee, sugary and carbonated drinks, chocolates, alcohol etc. Eat more fibre-rich foods. High-fibre foods can help relieve constipation which is a major culprit behind the overactive bladder syndrome.

If there is no severe medical condition that needs treatment by a doctor, then urinary frequency can be reduced by home remedies. Most vital is the kegel exercise which strengthens the pelvic and urethral muscles and supports the bladder.

Regular exercises can help in toning these muscles which aids to improve bladder control and also reduce urinary urgency and frequency. Bladder can be made to retain the urine voluntarily for a slightly longer time to increase its retention capacity and reduce frequency.

It is important to keep in mind that once the urge to urinate is extreme, it should not be held back but released;otherwise it may cause other problems and infections. Monitoring fluid intake and modifying diet can also effectively control frequent urination. Also, ayurvedic treatment can be used to cure pollakiuria.

Food that helps prevent frequent urination are:

1. Fruits:Bananas, grapes, apples, watermelon, strawberries, coconut, blackberries.
2. Vegetables:Asparagus, peppers, carrot, cucumbers, celery, broccoli, kale, lettuce.
3. Diet rich in fibre:lentils, artichoke, raspberries, almonds, beans, bran, barley, oats.
4. Diet rich in protein:Fish, eggs, tofu, Chicken.