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Feeling stressed, depressed and getting frequent urination. Medical test showed normal. Any treatment?

DOCTOR OF THE MONTH - Nov 2013
Nov 2013
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Neurologist
Practicing since : 1994
Answered : 5446 Questions
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Dear Doc,
Pardon me for the long post, but I feel the need to share whats going on. I'm about 42 yrs old, male. Due to work constraints, I have been away from my family for almost 18 months now, and hence very stressed out and depressed. Also, there is very little sunshine exposure for most of the year in this place, and hence taking extra Vitamin D and B12 supplements to compensate.
For the last ten months, i've had recurring symptoms of frequent urination, quite more than the normal. There were no other symptoms prior to this or coupled with this.
I've had all urological tests (2 ultrasounds, cystoscopy, cytometry, urine, blood) and a physical exam of my prostate which all have come out normal. Upon request from my chiropractor who has a specialization in neurology, i also had a basic saccral lumbar MRI without contrast. This showed normal results.
To subside my symptoms, my urologist put me on Ditropan & Vesicare which did not have effects even after taking for extended periods. On the other hand, they had side effects with respect to problems in voiding and retention. I was then prescribed Rapaflo which if taken only by itself seemed to help the retention, but caused me a different side effect in terms of causing cramps / pains in my rear, probably it was acting on my relaxing my prostate. Hence, i stopped all medications. I was also asked to just take warm water baths which may relieve some of these symptoms, but hasn't helped much either.
I am asking the question in the neurology forum mainly because all the urological tests did not conclusively say anything. I am worried and anxious if my symptoms are related to any neurological issue or M.S? I heard lack of Vitamin D could trigger M.S ?
Or could stress play a role in this? I don't have a history of any such issues on both sides of my immediate family.
Are there any neurological tests that you would prescribe? Or any medications?
Please help or advise me what to do further, and how to rectify this.
Appreciate your response.
Sincere Thanks XXXXXXX
Posted Thu, 25 Oct 2012 in Sleep Disorders
 
 
Answered by Dr. Sudhir Kumar 1 hour later
Dear Mr XXXXXXX
Thank you for contacting Healthcare Magic.
I have gone through your detailed description regarding your symptoms and treatment taken so far.
First of all, I am glad that all the tests have come out normal, which excludes any serious disease.
Regarding urinary symptoms, they can occur in neurological disease including low back pain, weakness or numbness of legs and shooting pain in legs (some or all of them may occur). Since, you do not have any other symptoms (other than urinary), they are unlikely to be neurological in origin.
You have mentioned about stress. Stress and anxiety could cause frequent urination. In this condition, increased frequency occurs in day (while awake) and not at nights (during sleep).
In summary, I do not think you have MS at this point of time, so, there is no need to worry about that.
Please get back if you have more queries.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad
Above answer was peer-reviewed by
 
Follow-up: Feeling stressed, depressed and getting frequent urination. Medical test showed normal. Any treatment? 1 hour later
Dear Doctor,

Thanks for your response. Although it is of some re-assurance, I am anxious because some of the other symptoms that you mentioned above did occur a couple of years ago, and not in the last ten months.

In detail, the following are what i recall:

a) Back in April of 2008, I suddenly experienced mid and low back pain, and underwent a 12 week physical therapy. I was told this was because of my bad posture and stress at work. After the therapy, the pain completely subsided although once in a while, i do get some upper neck pain.

b) Similarly, back in March 2010, I experienced low back pain along with some tingling in the feet and legs, as well as chronic head ache. I took blood tests (where i was mainly tested for levels of aldolase and creatine kinase (CK) as well as regular CBC. Initial tests showed a slightly elevated aldolase and normal CK, but a second test showed all levels to be normal. I also went through a 1 month physical therapy, and I felt fully better. During the same time, i was also told i had a low Vitamin D and was asked to take supplements.

c) Between April 2010 and Nov 2011 (for about 1.5 years), i was fully ok.

d) Nov 2011 - the urinary frequency symptoms started and is till recurring. And yes, the frequency is only during day time, and not in nights.

I just wanted to let you know the history and request your feedback, if any of the above would be a factor.

Sincerely appreciate your help / feedback.

Best Regards XXXXXXX
 
 
Answered by Dr. Sudhir Kumar 9 hours later
Thank you for getting back.
First of all, let me reassure you that since you do not have any of those symptoms now (for more than 10 months), they are insignificant.
Moreover, they were suggestive of another problem (local lower back issues), which responded to physical therapy.
Low vitamin D could also have contributed to your back problem.
In summary, your past symptoms were not connected to the urinary symptoms. So, as of now, I still feel that you do not have any neurological problem.
Please get back if you have more queries.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
Follow-up: Feeling stressed, depressed and getting frequent urination. Medical test showed normal. Any treatment? 2 days later
Thanks for your response.

I am anxious because one urologist whom i consulted (in the US) and who did all the tests seemed to be the opinion that he could not determine any organic cause for my symptoms (of either recurring frequency or retention), BUT the other urologist (in India) thought there may be some organic cause (i.e; its not a functional but a structural problem). But whatever medications they prescribed (based on their individual observations) did not seem to work.

Would you recommend any specific medications or any steroids that would help subside these OR any Ayurvedic or non invasive methods? Or do you feel stress management or some exercises can help?

Just as an FYI, I am also taking Vitamin B12 supplements as well, which was recommended by my PCP, when back in 2005 i was told i was deficient in it. Does this help for other issues?

Kindly advise.

Thanks much XXXXXXX

Kindly advise.
 
 
Answered by Dr. Sudhir Kumar 3 hours later
Hi,
Thank you for getting back.
I would not recommend any medications for your bladder symptoms.
Stress management should do at this stage.
Vitamin supplements may not help in bladder symptoms, but you should continue them.
Please get back for any follow up queries.
Best wishes,
Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by
 
Follow-up: Feeling stressed, depressed and getting frequent urination. Medical test showed normal. Any treatment? 4 days later
Hi Doc,

Thanks again.
Please advise if any more testing is warranted based on what's happened so far w.r.t. my symptoms and current condition?

Regards XXXXXXX
 
 
Answered by Dr. Sudhir Kumar 6 hours later
Thank you for getting back.
No further tests are required at the moment.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
Follow-up: Feeling stressed, depressed and getting frequent urination. Medical test showed normal. Any treatment? 26 hours later
Dear Doc,

Thanks for your responses. I just want to find out since i had many tests in the last 1 year or so - which includes Basic Metabolic Panel, CBC, cystoscopy, physical exam of prostate, and cytometry flow testing, how often should i get tested myself given my age? Like the basic BMP and CBC needs to be done every few years or so? Also, what other general physical tests do your recommend apart from above?

Please advise.

Kind Regards XXXXXXX
 
 
Answered by Dr. Sudhir Kumar 8 hours later
Hi,
Thank you for getting back.
Urological tests can be done as per the discretion of the urologist.
You should check your BP, blood sugars and lipid profile once a year.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
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