hi, I%E2%80%99m 39 years old, and from last several years
I%E2%80%99m 39 years old, and from last several years I have problem of frequent urination. From last one year in addition to frequent urniation I dont get a sense of completeness. It has happened several times when I think I%E2%80%99m done, and I close my trousers zip, suddenly more urine comes out to the extent spoiling the trousers. In short I always have this urge to go for urination even though I did like a minute back.
can you please help with the next steps or any invesigstion/ medicine.
Hello, I'm Dr. Branch, thanks for using Ask a Doctor. The evaluation for urinary frequency is extensive and detailed, but I will try to give a summary and you can let me know if you have any more specific questions. There are different kind of bladder problems that lead to incontinence like yours, including stress incontinence (urine leaks usually when laughing or coughing), urgency incontinence, in which the patient feels the need to urinate suddenly and frequently, overflow incontinence, in which the patient cannot empty the bladder and urine leaks when the bladder gets too full, and a combination of the above. Based on your symptoms, I would classify you as likely having urgency incontinence, and possibly feeling like the bladder is not empty because of whatever is causing the urgency feeling.
The evaluation begins with a urine test to look for urinary tract infections. Medications are reviewed to look for any that may be contributing, including alcohol and caffeine. Bowel function should be asked about. Then, a bladder stress test and a post void residual (in which the volume of urine in the bladder after urinating is measured) can be measured.
At this point, if urgency incontinence is confirmed, treatment can be started, starting with lifestyle changes (avoiding alcohol and caffeine, for example) and pelvic floor exercises, and trying a medication that helps the bladder muscle to relax, such as oxybutynin. If there are still significant symptoms after this, referral to a urologist is usually considered, and for extreme cases surgery is an option.
I hope that helps give you some ideas of what can be done for your situation, please let me know if you have any questions about any of that and I would be glad to discuss it further with you.