Urgency, small leak & frequency

  I can make as many as 20 visits a day.  Voids are 90-300mls.  When I have to go, it's usually urgent, and occasionally with a little leak before I make it to the restroom.  The urologist tried drugs for benign prostrate enlargement (interior enlargement was suspected) and ruled it out.  He's now got me on Oxybutynin 3X per day but it just dries my mouth and causes me to push harder, while STILL having the same urgent signals.  What could this be????
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Dear Steve, It seems you have severe urinary frequency and urgency.  What is your age?  If you are younger than 45-50 years, you may have some kind of bladder problem resulting in excessive bladder activity.  In medical terms we call it detrusor instability.  There are several reasons for these problems including infection, stones, and some types of neurologic diseases and rarely cancers.  Prostatic inflammation can also result in similar presentation.  
If you are older than 50 years of age, prostatic enlargement becomes more probable.  This enlargement of prostate may or may not be associated with all above mentioned pathologies.
I would recommend following course of action:  
You need to be seen by an urologist who will perform clinical examination and urine analysis.  If they show any blood or infection he will get further cystoscopic and imaging tests on you.  If they are normal he might plan to perform a test called as urodynamics.  In this test, tubes are inserted through the normal urinary passage  to assess bladder pressures and functioning.   This test might tell about detrusor instability (over active bladder), which can be treated through drugs.
If you are in prostatic enlargement age group, you may need further evaluation regarding benign prostatic hyperplasia (BPH) including rectal examination, International prostatic symptom questionnire, uroflowmetery and a serum prostate specific antigen estimation.  Following this you may discuss various treatments options for BPH with your urologist.
This information is provided for general medical information purposes only.
Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
The Henry Ford Hospital Department of Urology has experience in the evaluation and treatments of problems such as you describe. They would be most interested in helping you. You can reach them through our toll-free number (1-800-653-6568). We can also arrange local accommodations through this number if this is your need.
Sincerely,
HFHS M.D.-AT
*keyword: Frequency, Urgency