Urinary problems

[Christie04_returns]

I'm 49, non smoker, pretty healthy except for high blood pressure. Mildly overweight (or at least I like to think that!)

For the past couple years, I find myself going to the bathroom more and more frequently. I don't seem to empty completely unless I really bear down hard.  I'm going at least 3-4 times a night.  My stream will often stop unless I really concentrate on bearing down and emptying completely.  I can force out way more, even if I feel like I'm done.

My last pelvic exam was in June06, and everything was normal then, so far as the size of my uterus is concerned.  My doc didn't really have any ideas about the frequency, other than "You're getting older".  I have had a couple UA's done, no infection.  I don't have burning or anything else.  Just going more frequently, and having to work hard to empty completely.  I had a full blood chemistry panel last June, too.  

Any ideas what tests to pursue when I go to the doctor? I just moved and have to start over with new docs.  
Thank you.

[Lennox Hoyte, M.D.]

Urinary frequency is considered if you are needing to void more than 10-12 times daily (some authorities may consider frequency at 8-10 times daily). Usually, a specific cause cannot be found, but causes like excess fluid intake, UTI, prolapse, and diabetes need to be ruled out. It is important to know what happens if you do not answer the urge to void. (i.e., is there leakage or not). If there is incontinence (leakage) associated with delaying the urges to void, then please consider an evaluation to test your voiding function (post void residual and perhaps uroflow). If there is voiding dysfunction (e.g elevated postvoid residual), then prolapse or perhaps obstruction by an enlarged uterus needs to be considered and treated. If there is no voiding dysfunction and the workup is negative for bladder infections, then you should consider behavioral therapy, medication, or electrical stimulation to address your frequency/urge incontinence. If there is no incontinence if you delay the urge, then behavioral therapy in the form of timed voiding, or pelvic floor physical therapy or medication may be of help in making the situation better.  Getting up multiple times at night is a more complex problem, and may be associated with frequency, or it may be caused by sleep disturbances (sleep apnea) or excess late night fluid intake.  Sometimes fluid imbalances can cause fluid to collest in the feet while upright, and to be drained to the kidneys when you lie down at night.  It would be a good idea to get the frequency problem solved first. If the nighttime excessive urination then persists, then you should be evaluated for some of the above causes fot excessive urination at night (also called nocturia)

[mmf2604]

Have you had a urinary analysis done to rule out infection?

I had frequency and it turned out that I have a disease called Interstitial Cystitis.  You may want to do a search on that and see if the symptoms match yours.  The hesitancy with urination and the full feeling is also what I had.

I would suggest going to see a urologist, one that specializes in IC, so atleast you will have them rule that in or out for you.