Why do I have frequent urination?

February 3, 2012 10:18 PM

Why do I have frequent urination?

I know you are not my doctor.
I have had this problem for about 6 months.
I am a 28 year old male.

Frequent need to urinate. I do it about 15 times a day, and often have to
wake up in the night to go too.

The amount I urinate is very small, maybe about 100 ML or 25% of a can of coke.
I have no pain in urination, no burning, but I do sometimes feel that not all of the pee has come out, and I have a weak urine stream.
I have no other symptoms and no pain.

I went today to the doctor, they checked my urine, and found no infection or abnormalities, and
did an ultrasound on my prostate and kidneys and reported normal shape and size.

I work a desk job, I do sports regularly, I'm vegetarian, I drink about 1 beer a day 5 nights a week. I don't drink soda or caffeinated beverages.

Anyone have any idea what it could be?

I took Amoxicillin for a 8 days every 8 hours to no avail

posted by anonymous to health & fitness (18 answers total)

IANAD, but I have a similar issue, and I know that there were several things I got checked for. First, you could have a physical issue such as a stricture that blocks urine flow, or a bladder problem that would result in urine staying in the bottom at all times. The second possibility is something like interstitial cystitis, which is what I have, but I'd expect more pain or something with that. A third possibility is an STD or other viral infection that wouldn't be affected by the antibiotics you took, but I assume that this would have shown up in your urine screen.

Regardless, if you haven't, you should see a real urologist, not just your regular doctor. (Get a referral if you need to for insurance.) They may need to do further testing.
posted by tau_ceti at 10:28 PM on February 3 [1 favorite]

The doctor tested your blood sugar, right? Frequent urination can be a sign of diabetes (which I assume they checked for, but it never hurts to ask).
posted by McPuppington the Third at 11:10 PM on February 3 [3 favorites]

McPuppington asks a good question. Also, is your urine dilute or concentrated (is it dark/gold or pale/clear? I might assume by "no abnormalities" that your doctor didn't consider your urine to be extremely dilute, but it never hurts to ask.) Are you experiencing any abdominal discomfort or cramping or flank pain? Do you ever experience incontinence or "dribble?"

Just based on what you've posted, it sounds like overactive bladder, which unfortunately is like saying, "you have what you have." It's almost more like a symptom than a diagnosis. Have you ever had a head or neck injury or a stroke? Do you experience muscle spasms or numbness anywhere on your body? Also, do you ever notice swelling (especially in your legs and feet)?

When a man complains of urinary frequency, most doctors minds will probably jump to infection and prostate issues. If your regular doctor has ruled those out, the next things you'll want to look at are physical abnormalities (like tau_ceti mentions) or neurological/endocrine issues like diabetes or multiple sclerosis because those body systems are also involved in the regulation of urination.

I agree with tau_ceti that the first place you should go is to a urologist. A urologist should be more familiar with that body system. If you have something unusual, a specialist would be more likely to diagnose it and more quickly. They would also be more knowledgeable about treating something uncommon. (Of course, you could have something common, just with an unusual presentation, but a specialist would be better able to catch that too.)

Good luck!
posted by alittlecloser at 12:06 AM on February 4 [1 favorite]

I would not assume that viral infections were checked in a urine screen that anonymous took today. If it was done in-house while he waited, it was probably just a standard dipstick test for the presence of leukocytes, blood, and bacterial proteins. So don't go ruling out viral STIs or resistant bacteria just based on that.

I echo the sentiments to go to a urologist for a more thorough workup on all fronts.
posted by deludingmyself at 12:15 AM on February 4

I am seconding the recommendation for a urology referral, but this really ought to be something your primary care physician can make progress on. I think these symptoms tend to get dismissed in young men, with physicians focused on prostate problems in older men, and incontinence in women. You need to go back to your doctor and make it clear that this is having a significant impact on your quality of life, and that you want to discuss treatment options.

The standard work up is actually pretty standard, and your doctor sounds like they have done some of the most important steps in initial assessment, although you don't sound like you have done a bladder diary, or had a neuro exam, or had any blood tests.

The commonest cause of these symptoms is urological, and among the common urological causes, overactive bladder is really the "catch-all" diagnosis. If that is the likely diagnosis, then your primary care physician could start medication (like Vesicare / Toviaz etc), recommend bladder retraining, or suggest lifestyle modifications (less beer). It's fine to see a urologist to sort this out, but your primary care physician needs to exclude diabetes mellitus, diabetes insipidus, and anything neurological first.
posted by roofus at 12:39 AM on February 4

Frequent urination is a sign of diabetes because you produce a lot of urine; the OP isn't producing too much urine, he is feeling the urge to urinate when his bladder isn't even close to being full. That's a different thing entirely.

OP: There's a bunch of things that could cause your symptoms but there is no point in wild ass guesses with no basis. You need to see a urologist and any other specialists he or she feels are prudent.
posted by Justinian at 1:36 AM on February 4 [1 favorite]

If you have not had it yet, a fasting blood sugar test can confirm or rule out insulin resistance (pre-diabetes) or diabetes itself. Just a urine test is not sufficient.
posted by mermayd at 3:32 AM on February 4

Apart from physical causes, I know when I am stressed or anxious I often feel the need to pee a lot, and don't feel "done". The not-done feeling I think comes partially from the mini-pee's done cos I am peeing every hour of the day, it doesn't feel the same to your body as the more usual pee that you otherwise do (and have done at least 30,000 times).
posted by Iteki at 6:17 AM on February 4

One more vote for a urologist, both to rule out physical issues and to discuss other possibilities. I had a less severe version of what you describe, went to the urologist and got some odd and uncomfortable exams (and a really cool trip to the hospital imaging center to drink some radioactive stuff and watch it move through my system in real time), and in the end he basically said it was in my head and that my brain/bladder interface needed retraining (as in, I had inadvertently taught my body to "need to go" before it really needed to go, if that makes sense). There are both medications and techniques to help with this, and it appears to be super common. A few years later and as far as I can tell things are totally normal.

I'm not saying that this is your issue -- just that visiting a good urologist is your mandatory next stop, and that whether your issue is physical or not, there are options that will help. Don't try and figure it out yourself on the internet, and don't just accept that this is the way it is. And if the first urologist is unhelpful or blows you off, go see another one. It's a real issue and it's impacting your quality of life.
posted by Forktine at 6:19 AM on February 4

I would see a doctor/urologist, but also do some reflection. Have you been drinking more water lately? I used to think I had a problem(I'm female) because I thought I must be peeing a lot more than most people, but then I realized that I drink more water than most people. It is mindless.

I didn't really notice I was doing this until I had a front desk job where I had to get someone to cover me if I had to use the restroom. Often it happens when the office is too cold and I find that I am constantly downing hot tea to stay warm. So think about your habits that you may not be aware of.

Also consider nervous/stress pees.
posted by fromageball at 9:51 AM on February 4

Visit the Interstitial Cystitis Network. Its a fantastic resource and you can do tons of research and ask questions even if you don't have IC the folks there are expert on all matters related to urinary functions.

http://www.ic-network.com/

When the urinary function gets out of whack it is so stressful and painful it quickly takes over your whole life. It did mine. You become obsessed with "going" -its all you can think about.

Hope you find answers. A good urologist is worth their weight in solid gold, believe me. You can get personal referrals at the ICN, too.
posted by Tullyogallaghan at 9:51 AM on February 4 [1 favorite]

Oh, I forgot to agree with "Forktine" - stress/anxiety is a HUGE issue as we can be pressing down on our poor bladders out of nerves - even when we are asleep and not even be aware of what we are doing.
posted by Tullyogallaghan at 9:56 AM on February 4

I've had this problem for awhile...and when I say awhile, I mean like 5 years.

I think for me it was originally a sudden onset physical cause and because it was so dramatic and intense, it freaked me out and then once that was cured (if it's cured?) my nerves just took on their own life in terms of giving me the 'must pee NOW' signals.

Finally it's more manageable, you can take pills like enablex, vesicare etc but what seemed to work for me unfortunately was time and now..potentially acupuncture. Fingers crossed.

The above commenter is right, it takes over your life and it is so annoying and embarassing and limiting in some ways (2 hr car ride...um, no). etc.

Anyway, see as many doctors as you can, as quickly as you can. If that doesn't work try acupuncture. Try relaxation methods. Try to 'retrain yourself' IF you have a job that gives you the freedom to leave for the bathroom whenever you want. (I don't, unfortunately).

Wow, I should have made a secret account for this but I just wanted to say that I feel your pain! (or lack of pain).

Also...did you have a triggering event 6mths ago? Was it sudden onset? Things to mention to dr. and think about for yourself too to try to get to the bottom of it.
posted by bquarters at 11:10 AM on February 4

Are you me? This exact thing happened to me too and I'm only a few years older than you. I went to a urologist, got scans, got my pee tested over and over, was put on meds, etc. Nothing helped. No sign of an infection, no sign of anything. I was peeing all the time. Weak stream, never feeling empty, etc. I probably was peeing 2-4 times an hour.

Then one day it stopped. I suspect my prostate was infected and the antibiotics didn't help and it healed over time. Mine last 3 months. The only thing I can think of that might have set it off was adding 500mg of vitamin C and going on a diet.

Perhaps you should seek a proper urologist.
posted by damn dirty ape at 11:20 AM on February 4

Check out this earlier thread: http://ask.metafilter.com/196953/How-do-I-stop-having-to-pee-all-the-time.
posted by PickeringPete at 1:05 PM on February 4

I'm a woman, so I can't comment on prostates and whatnot in any meaningful way, but I did have a similar problem with what was described as 'overactive bladder' and basically dismissed. Even the urologist that I saw told me that it was probably a life-long thing that I'd need to "get used to" once I mentioned that I didn't drink excessive coffee or pop or whatnot.

You noted that you don't drink soda or caffeinated beverages - are you eating or drinking other things that are diuretics, though? I eventually determined, with no help from the medical community, that my problem was being caused by drinking coffee in the morning followed by cherries and cherry juice in my morning smoothie. When I significantly dropped down the quantity of cherries/cherry juice, replacing them with other fruit, the urge to pee declined significantly and continued to decline to the point where it's basically normal. I also found that I needed to drink a lot less (go figure) than I did before and, when I do pee, it's a 'normal' amount and not little bits here and there.

(It comes right back, though, if I consume too much of a diuretic food/beverage. It then takes a day or two to settle back down.)
posted by VioletU at 3:27 PM on February 4

I think the most important missing piece of information is how much water you drink. IANYD, etc.

It's true that fasting blood sugar testing or other blood tests are the standard for diagnosing diabetes, but if you had diabetes then it should have been picked up because you would be leaking glucose into your urine, which the standard dipstick test includes.

I wouldn't worry too much about viral STIs as a poster mentioned above. Yes, viral STIs like HPV and herpes do exist but they don't typically cause frequent urination as a symptom (HPV=either no symptoms in men or genital warts, herpes=skin lesions).

What sort of plan did your doctor give you when you left the office? Do you have a follow up scheduled? Do you have other testing scheduled? If not, call the office and make a follow up. One of the things that can be tough with embarrassing medical symptoms is that you feel too shy to discuss them much, and so your doctor can get the impression that it's not that big a deal to you and consequently do a more cursory workup. At your follow up you can talk about other basic tests that could be done or whether to jump to a urologist referral.
posted by treehorn+bunny at 1:07 PM on February 6

you don't say if you are currently on any daily meds - but if you are, that's a possible explanation (though your doctor should have caught this). things like lithium will make you pee all.the.time.
posted by unlucky.lisp at 10:37 AM on February 7