Urogynecology Expert Forum
Frequent urination
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Questions in the Urogynecology forum are answered by Bruce Crawford, MD, J. Kyle Mathews, MD, and other medical professionals and experts. Topics covered include overactive bladders, bladder pain, fallen/drooping bladder, bowel urgency, bowel prolapse, cystitis, incontinence, pain with intercourse, rectal prolapse, surgery, urinary urgency, and uterine prolapse.

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Frequent urination

Hi there.  I am a 33 year old female, 5'3", 110 lbs, and I have fibromyalgia and a clinical diagnosis of Lyme Disease (no positive blood test).  I've had a lot of symptoms for over five years, one of which is a problem with frequent urination and feeling the urge to go immediately after voiding (I mean immediately, before I even leave the bathroom).  On a good day I will be able to hold it so that I only go once every 1.5 to 2 hours, but sometimes I have to go every hour, and when I drink anything, if I don't sip it slowly but instead take in several ounces at one time, then I will literally go immediately (about 5 minutes after drinking) and have to go 3 times in a half hour.  I now barely drink anything all day because of this.  For instance, today I just finished a 16 oz bottle of water that I opened 5 hours ago.  I have urinated 6 times, all 6 times the urge to go was very strong and all 6 6 times I only urinated a little bit of clear urine--and that 16 oz bottle of water is the only thing I've had to drink all day.
At night it's worse.  I will go, stand up, feel like I have to go again, so I'll sit back down and "trickle" and then go to bed.  15 minutes later my bladder will feel extremely full, and I'll go back to the bathroom, where I'll void a very small amount of urine and still feel like I have to go.  If I just stayed in there I would probably void a tiny amount of urine (probably not even 1/8 of a teaspoon) every 10 minutes or so all night. Sometimes I'll wake up between 3 and 5 times during the night.
Sometimes I feel pressure in my bladder, but I wouldn't call it pain, and the urine is usually clear or just slightly yellow.  It never hurts to pass, and I've had a few negative UTI tests.  I've never experienced any leakage either.  I just go a lot and usually don't feel like my bladder is completely empty.  Do I just have a small bladder, or is this normal?  
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Get checked for a bladder infection. If this is positive, get treated with antibiotics. If the culture is negative, you probably are dealing with a problem called overactive bladder, where you feel like you have to urinate all the time.  YOu can sometimes get relief from a pill  like Detrol or Vesicare, taken daily. Often, this problem is associated with active, painful trigger points in the pelvic floor muscles, which can feel like a need to urinate.  You probably need an evaluation by a gynecologist/urogynecologist, and then by a qualified pelvic floor physical therapist, who can work on your pelvic floor muscles to release the trigger points, and possibly cure your urinary urges.

Dr. Hoyte
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J. Kyle Mathews, MD, DVMBlank
Plano Urogynecology Associates
Plano, TX
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