What to know about urinary urgency

Symptoms

Urinary urgency occurs when the pressure in the bladder builds suddenly, and it becomes difficult to hold in the urine. This pressure causes a strong and immediate need to urinate.

Urinary urgency can occur regardless of whether the bladder is full. It can also make a person want to urinate more frequently than usual. Some people experience urinary urgency infrequently while others notice it throughout the day.

It sometimes, but not always, occurs alongside urinary incontinence, which is where a person involuntarily passes urine.

Sudden movements that put additional pressure on the bladder, such as coughing or laughing, can cause some urine to leak out of the urethra.

Causes

Urinary urgency is unlikely to have a serious cause, but it can be disruptive to a person’s daily life. Many different factors can affect bladder function and cause urinary urgency.

A common cause is an overactive bladder (OAB). OAB is a condition in which the bladder puts pressure on the urethra to release urine even when it is not full.

Another common cause is a UTI, a common infection that occurs due to bacteria in the urinary tract. People may experience a burning sensation while urinating and notice cloudy or bloody urine.

Other causes of urinary urgency include:

• consuming too much liquid, especially alcohol or caffeine, which are both diuretics
• interstitial cystitis
• a vaginal infection
• a prostate infection
• an enlarged prostate
• a side effect of certain medications, including diuretics
• diseases that affect the nerve endings, such as multiple sclerosis and diabetes
• damage during childbirth or surgery
• pressure on the stomach, for example, due to pregnancy or obesity

Diagnosis

To diagnose the cause of urinary urgency, a doctor will perform a physical examination, ask about the person’s symptoms, and assess their medical history.

The doctor will try to determine the frequency of urinary urgency, the time of day that it tends to occur, what fluids the person consumes, and what medications they take. In some cases, a person may need to keep a record of these factors to help the doctor determine a cause.

Doctors may also use some tests to rule out the possibility that the symptoms are due to a health condition, such as an infection. They may request a urine or blood sample for analysis.

Sometimes imaging and bladder function tests are also necessary to test for any damage to or dysfunction of the bladder.

Treatments and home remedies

The treatment options for urinary urgency will vary depending on its cause.

Lifestyle changes

Drinking less liquid and avoiding caffeine and alcohol can help. Avoiding smoking and maintaining a healthy weight may also be beneficial.

Bladder training

Bladder training, which involves timed voiding, is an effective method for managing urinary urgency.

Timed voiding is where a person keeps a bladder diary and works with a doctor to determine a regular schedule for using the toilet.

People can gradually increase the time between toilet visits to train the bladder to hold urine for longer and reduce the frequency of urinary urgency.

Physical therapy

It is common for a doctor to prescribe physical therapy. This therapy will involve strengthening the pelvic floor muscles to support the urethra, the tube that carries urine out of the body. Strengthening these muscles can lead to a reduction in the number of times that urinary urgency occurs.

Medications

Several medications can treat urinary urgency. Some drugs, including antimuscarinics such as oxybutynin and tolterodine, aim to relax the bladder.

Different medications will help with different causes. For example, if the cause is a urinary tract infection, a course of antibiotics will be necessary.

Medical procedures

In severe cases, a person may need surgery or a medical device, such as a catheter, to help them empty the bladder. Another option for more persistent cases is electrical nerve stimulation, which involves the use of electrical pulses to stimulate bladder function.

Prevention

Some tips for preventing urinary urgency include:

• eating a healthful diet
• drinking enough fluids to urinate every few hours
• maintaining a healthy weight to reduce pressure on the bladder
• developing a consistent urination routine through bladder training
• avoiding smoking
• doing regular physical exercise, focusing on strengthening the pelvic floor muscles
• limiting alcohol and caffeine intake

Complications

Urinary urgency can disrupt daily functioning. Without proper management, frequent bouts of urinary urgency can make daily tasks more challenging and even affect work performance. Some people may become more physically inactive as a result of urinary urgency.

If urinary problems affect a person’s mental well-being, they can speak to a doctor about ways to manage their symptoms.

Outlook

Urinary urgency can affect a person’s daily life. A doctor can diagnose the underlying cause and recommend treatment to manage the symptoms. People can also make some lifestyle changes and try bladder training to minimize urinary urgency.