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Dr. Andrew Rynne

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What causes urinary urgency post menopause?

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Dr. P. T. Patil

Urologist

Practicing since :1971

Answered : 9938 Questions

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Posted on Wed, 21 Oct 2015 in Urinary and Bladder Problems
Question: Hi, I suffer from urge to urinate whenever lying down and sometimes every half hour all night! I read on this board about trigonitis which sounds likely. Would the trigone be irritated less by right side lying or left side lying or back lying? What diagnostic tests would be needed? Thank you
doctor
Answered by Dr. P. T. Patil 1 hour later
Brief Answer:
Could be due to Post Menopusal Urethral Stenosis,

Detailed Answer:
Hello
Thanks for your query ,based on the facts that you have posted it appears that urgency for urination that you have is likely to be due to what is ccaled as Post Menopausal Urethral Stenosis

I shall be happy if you can post me few more details to help me in making comments on your problem.
1) Do you have other urinary symptoms like burning ,increased frequency etc?
2) Was your urine culture done any time and what were the findings ?

The cause of urgency and increased frequency in female in post menopausal age group is mostly due to what is called as Urethral Stenosis.

After the menopause there is generalized atrophy of all Genito Urinary organs that also involves urethra causing narrowing of urethral passage .This narrowed urethra causes incomplete emptying of the bladder which results in to significant amount of urine to remain in bladder what is called as post void residual urine .
This residual urine is the source of infection giving rise to symptoms like urgency and frequency .

Please get your routine urine test and urine culture done to find out the organisms causing this infection and antibiotics to which they are sensitive to.

Please take broad spectrum antibiotics like Cefixime along with urinary antiseptic like Nitrofurantoin twice daily and urine alkalizer thrice daily .Later on switch on to appropriate antibiotics as per culture report.

Get the prescription of medicines from your family Physician.

Ensure to drink more water .To keep your urine dilute This will help to control dysuria.

Please consult qualified Urologist for clinical examination and get following basic tests done to confirm the diagnosis.
1) Urine routine and culture.
2) Ultrasound scanning of abdomen and pelvis
3) Endoscopic Examination of bladder (Cystoscopy).

If needed he may do calibration of urethra at the same sitting .which should be followed by self intermittent catheterization by yourself at home for 2-3 months .

Discuss this modality of treatment with your Urologist .

Hope I have answered your query ,please feel free to ask if you have more questions ,I shall be happy to help you
Thanks and Regards.
Dr.Patil

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. P. T. Patil 10 hours later
Dr. XXXXXXX
Thank you very much for your very informative reply!

As to your questions, no i do not have any other symptoms and I do not have these symptoms during the day, and yes I had a urine culture that was negative.

My sister died at age 50 from cancer that began in her ureter, but she had intense back pain and problems uirinating at all. (She kept refusing to have any diagnostics of her back pain because she was in denial. Eventually when her body could no longer clean her urine she became psychotic and was taken by police to a hospital where it was discovered that she had metasticized cancer.)

I have made an appointment with a urologist. Your reply is very helpful to me in getting questions ready.

Do you have additional recommendations based on this further information?
doctor
Answered by Dr. P. T. Patil 57 minutes later
Brief Answer:
Do write after you consult Urologist and investigated .

Detailed Answer:
Hello
Thanks for follow up .Please do write after you consult urologist and the details about findings on Cystoscopy and investigations done .

I shall be happy to address your concern .
Thanks and Regards
Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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