What is the cause and treatment for frequent urination?

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Posted on Mon, 27 Jan 2014 in Urinary and Bladder Problems
Question: I have to urinate often ..... if I stand up from sitting position or sleep position. And I empty out every time. My family Dr. thinks my bladder has fallen and there by impairing the normal muscle function that holds the urine until some normal level. I have had this condition for about 2 years and j just now learned about 'fallen bladder' as a possible cause. So far I have resisted all medications because the Drs. always talk about medicine to help you empty out because you are only letting out part of your urine fill .... then go again to let put more ...then go again etc. Is there such a thing as 'fallen bladder'? And is there a physical solution to raise the bladder back up to more normal position so the muscle system can work more normally? Thank you. XXXX
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Answered by Dr. V. Sasanka 25 minutes later
Brief Answer: Medications very likely to help Detailed Answer: Hi, I suggest you have few basic tests - these include an ultrasound of your kidneys and bladder and prostate, a urine analysis for any indication of urinary infection, and a uroflowmetry to assess the speed at which you are passing urine. You can get the sonologist to see how much of urine is being left behind after you void urine. I see no reason why you should resist medications - most of them are very safe. If your flow rate is slow, and if some urine is staying behind after you pass urine, drugs like Flomax which are called alpha-blockers could help significantly. In the first few days after you have been started on the medicines, you might develop a mild reeling sensation, especially after you have lying down, but this soon passes, and rarely needs discontinuation of medication. You will find urine flow to be better tha earlier, and frequency could come down to a comfortable level If the flow rate is very good, and the problem is only frequent urination, your bladder could be overactive, and you could benefit from medication like Vesicare or Detrusitol which belong to a group of drugs known as anti-cholinergics. The problem is - they can cause dry mouth, and vision disturbances, and might even get your bladder to shut down completely in high doses so taking them alone initially might not be a good idea. I doubt if 'fallen bladder' is an issue. It is more likely in females. Hope I have been able to help you.
Above answer was peer-reviewed by : Dr. Shanthi.E
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Follow up: Dr. V. Sasanka 24 hours later
Dr. Sasanka: Thank you for your reply. Please note when I urinate I "empty out". If I remain seated or in sleeping position I have no unusual urinary function. But every time I stand up, either immediate or 5 0r 10 minutes, what urine that collected from last time wants to come out and I cannot hold it back. Do you follow the events..... urinate, sit or sleep for some time, do not need to urinate, but when I stand up I have to urinate immediately or within 5 or 10 minutes, then the cycle repeats the next time I stand up .... also if I remain standing I will get the 'urge' again far sooner than during my earlier days. Note: When I am in sleeping position, I am horizontal (no gravity pulling urine downward. Note: When I am in sitting position my torso is at right angle to my upper legs (here gravity is pulling down on parts below my waist but some how the 'passageway' is being squeezed and closed off. I believe, thus no urgency as urine accumulates). Note: I am not anxious to take any pills for the rest of my life for any of these conditions if there is an alternative. I would rather cure the condition rather than just treat it until my 'end'. Thank you for re-visiting my inquiry. XXXX
doctor
Answered by Dr. V. Sasanka 16 hours later
Brief Answer: Post Void dribble? Detailed Answer: Hi again, I am just wondering if there is a possibility that you have a condition called Post-Void Dribble. This is a situation where some urine gets collected in a pouch of the urethra below the level of urinary sphincter after you finish voiding, and when you get up,the urine causes an urge to empty and indeed does dribble away into the undergarments. The anatomy can be assessed by means of an X-ray called Retrograde Urethrogram (RGU) or MCUG. This, (if it is indeed the condition that you have) does not need any treatment, but you would benefit from staying back at the toilet after you finish voiding and milking the urethra out from scrotum up. However, I would still prefer that you do get the tests done which were mentioned earlier, as there are other conditions such as bladder diverticulae which could cause symptoms that you have described, but are essentially mechanical events, and usually do not respond to medications or life style adjustments. Hope I have been able to help you again.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. V. Sasanka

Urologist

Practicing since :1995

Answered : 529 Questions

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