Frequent urination: specialists and information

Frequent urination is when you feel the need to empty your bladder more than six times a day or twice a night. There are two different forms. Identifying the cause is necessary for treatment. Keeping a micturition diary can help with this.

Below you will find further information and specialists for increased urination.

Definition: What is frequent urination?

The urine produced in the kidneys collects in the bladder until it is full. It holds about 0.4 to 0.5 liters. When the bladder fills up, there is a natural urge to empty the bladder - the urge to urinate. Normally, this natural urge to urinate occurs in an adult

• up to six times a day and
• a maximum of twice a night

at night.

The urge to urinate is said to be frequent if the bladder presses more than six times a day or twice a night © Satjawat | AdobeStock

Normal daily urine production and excretion depends on fluid intake. If you drink 2 liters a day, this amounts to around 1.5 liters.

If the daily urine volume exceeds a value of 2 to 3 liters per day, this is referred to as polyuria. This is the symptom of pathologically increased urine excretion.

Those affected often only excrete small amounts of urine

In principle, one can speak of a pathologically increased urge to urinate if

• you can no longer sleep through the night.
• you have to go to the toilet much more frequently during the day than before.
• urination takes longer than usual.
• you notice that urine dribbles out.
• after urinating, you have the feeling that your bladder has not been completely emptied.
• you repeatedly feel a sudden and very strong urge to urinate.

Forms of increased urge to urinate

Doctors differentiate between two forms of abnormal, increased urge to urinate:

• Pollakiuria: Frequent urge to urinate without producing and excreting more total urine per day. Instead, small amounts of urine are passed more frequently throughout the day.
• Nocturia: Increased urge to urinate, especially at night, i.e. more than twice.

How many people are affected?

Men over the age of 50 are particularly affected by an increased urge to urinate. Around one in three men over 50 complain of frequent and nocturnal urge to urinate.

In most cases, this increased urge to urinate is a sign of the onset of benign prostate enlargement. It can start as early as the age of 30 as part of the natural ageing process.

What are the causes of an increased urge to urinate?

A pathologically frequent urge to urinate can have different causes.

If the urge to urinate is only occasional, these include

• Excessive fluid intake,
• excessive alcohol or coffee consumption or
• the intake of dehydrating medication - so-called diuretics (colloquially known as "water tablets").

Psychological strain and stress can also be the cause of an increased urge to urinate.

If the increased urge to urinate occurs over a longer period of time, this is often a sign of another underlying illness. Diseases that can cause an increased urge to urinate include

• Diabetes mellitus,
• diabetes insipidus,
• the 3rd stage of acute kidney failure,
• inflammation of the prostate(prostatitis),
• prolapse of the uterus,
• a pathologically increased sensation of thirst (polydipsia) and
• impaired concentration performance of the kidneys (hyposthenuria).

Weak pelvic floor muscles can also result in an increased urge to urinate. Childbirth or obesity can weaken the pelvic floor muscles.

The urge to urinate, which occurs more frequently at night, i.e. when lying down, can be caused by

• an inflammation of the bladder or
• benign enlargement of the prostate (prostatic hypertrophy)

may be responsible. Causes of an increased urge to urinate without increased urine production and excretion (pollakiuria) include

• Prostate diseases,
• the so-called irritable bladder and
• the early phase of pregnancy

are possible causes.

How is an increased urge to urinate diagnosed?

In order to provide suitable treatment, the doctor must first clarify which disease or cause is causing the frequent urge to urinate. The first step is to take a medical history, during which the doctor asks the patient about their symptoms. This may look something like this:

• When and in what situations does the urge to urinate occur?
• Does the urge to urinate only occur at night or also during the day?
• How often does the urge to urinate occur?
• Has the daily amount of urine excreted increased?
• What did you eat or drink before?
• What medication did you take before?

A micturition diary can also help to determine the causes. In the micturition diary, the affected person documents when and in which situations the urge to urinate occurs.

A blood and urine test is also useful for diagnosing an increased urge to urinate. Among other things, blood sugar levels, electrolyte concentrations and creatine levels are determined.

Imaging procedures, such as

• ultrasound examination of the urinary tract and prostate and
• cystoscopy,

can also be used to diagnose frequent urination.

What is the treatment for frequent urination?

The treatment of pathologically increased urination depends on the underlying cause of the urge to urinate. If frequent urination is caused by another underlying disease, it is necessary to treat the underlying disease in question.

If there are no organic causes, bladder training may be able to help. This involves the affected person consciously trying to suppress or regulate the urge to urinate. In this way, the bladder can gradually get used to filling up again.

Psychologically induced urinary urgency can be treated with psychotherapy or relaxation techniques. Possible therapies include

• autogenic training or
• progressive muscle relaxation.

Medication for increased urination

There are also some effective medications available from pharmacies to treat increased or nocturnal urge to urinate. With their help, those affected can reduce, suppress or better control the urge to urinate.

These include, among others

• anticholinergics and spasmolytics, which reduce the bladder muscles' ability to contract, or
• active ingredients from saw palmetto fruits and nettle roots, which both reduce the urge to urinate and improve urinary control.

Men can also take alpha blockers, which relax the muscle cells of the prostate. For women, taking oestrogen can help to suppress the urge to urinate.