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Frequent Urge to Urinate

  Since last Monday I have noticed a frequent urge to urinate, may times frequently after already urinating. I went to my doctor on Wednesday and he did an in office urine test which yielded nothing other then a trace of protein, an acutest was done for blood and the number was fine (110 on a scale of 50-150.  He did a rectal exam of my prostrate and found it to be normal size.  Frankly he doesn't know and wants to see me in two weeks. At the time I noticed this I had completely quit drinking coffee (was a heavy coffee drinker in morning hours), and had quit taking an appetite suppresent that I had been taking to help me loose weight (only took it for about a week. . .Thin Tabs plus).  At times I feel almost normal.  If I ignore the urge to urinate it will eventually subside and I can usually go for some time ane then the flow is quite good.  I do notice that the urge is not near as overwhelming when I am standing or keeping busy.  I have no pain, no history of any problems and at a full physical in April all of my urine and blood work are fine with no numbers out of order.  I have over the last four to six months lost about 20 lbs and work out every day and I feel great.  My doctor seems to think that the sudden drop of caffine and the discontinuing of the appetite suppresent may be partly to blame.  My urine test showed no sign of infection.  However, could I have had one and it didn't show up in the in office test?
  Any advice would be welcomed.
Dear Bob
Thanks for sharing your symptoms.  
A urinary tract infection does cause similar acute symptoms and should be checked for by a urine culture which usually takes two days to process.   A dipstick urinalysis is only a screening tool and is used by some labs  as a marker for which urine specimen should be cultured.    A bladder tumor or passing kidney stone are less likely if  no blood cells were seen on the urinalysis, but not unheard of.  Another diagnosis is an unstable bladder (detrussor instability).  The etiology of  this condition is unknown but is exacerbated by caffeine consumption.  Some appetite suppressants contain caffeine and alpha adrenergic stimulators. These could lead to such symptoms but their discontinuation should have provided relief if these were the cause. Increase fluid consumption makes the symptoms worse.  Ditropan, Detrol and Levsin are anticholinergic medications which can help with the symptoms but can have infrequent side effects (dry mouth, constipation, blurred vision).  
   More individualized care is available at the Henry Ford Hospital and its urban campuses by calling  (1 800 653 6568). We can also arrange local accommodations through this number if this is your need. Please bring any physicians
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