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Urge to Urinate with Pressure on Bladder

  I am a very healthy female in my mid-20's.  Around the end of April
  I began having some discomfort out of all of a sudden.  I feel
  like I have to urinate constantly, but when I go, I don't have
  any good pressure to void all of the urine out.  When I stand up
  I feel like I need to go again and again, but very little comes out
  with a lot of effort.  I went to my doctor who tested for UTI, and
  did not find any bacteria.  She referred me to a urologist who probably
  thinks I'm a fruitcake because he doesn't think anything wrong.  He
  did a quick exam the first time we met looking at the urethra
  and didn't find any obstruction or blood.  So he gave me Urised,
  which didn't work. This last time he gave me Detrol to take
  before we opt to do a cystoscopy ( spelling ?).  I don't want
  to do this because I generally dislike any pain. Anyway, the dr.
  said that he doesn't think he will find anything with this procedure.
  Am I crazy?  I am urinating approx. 16-20 times a day, only drinking
  about 6 glasses of H2O.  I constantly have discomfort, but not as
  bad when I lay down. I feel like something is sitting on my bladder
  and I need to carry it.  
  The Detrol is not really helping. In fact, I feel like it is
  making it harder to "push" or pass the urine.  
  Could you please advise of what procedure needs to be done,
  or if it will maybe just go away?  It has been four months.
  Desprately seeking advice,
Dear GIGI,
You are probable correct when you say that Detrol will make it harder for you to push the urine out because it works by relaxing the bladder muscle.
Ureteral stones are a common cause of sudden onset urinary frequency in an adult and needs to be ruled  out by an intravenous urogram even in the absence of blood in your urine. Anything pressing on the bladder such as an ovarian cyst, pregnancy, etc. can also cause urinary frequency.
Another condition that has similar problems that is a diagnosis of exclusion is interstitial cystitis.
I sympathize with your condition and plan to provide you with information such that you can understand that you are not alone many people have the condition known as interstitial cystitis(IC).  This is a chronic inflammation of the bladder wall and unfortunately there is not a known cure.  It differs from common cystitis in that the later is caused by a bacterial infection which can be treated by bacterial antibiotic therapy.  It is also important to note that IC is not a psychosomatic disorder nor is it caused by stress.
IC can affect people of any age, race or sex.  It is, however, most commonly found in women.  A 1987 epidemiological study estimated that 450,000 people may be affected by the disease.  The symptoms include:
-Frequency-Day and/or night urination(up to 60 times a day in severe cases.)  In early or very mild cases, frequency is sometimes the only symptom.
-Urgency-The sensation of having to urinate immediately may also be accompanied by pain, pressure or spasms.
-Pain-Can be in the abdominal, urethral, or vaginal area.  Pain is also frequently associated with sexual intercourse.
-Other Disorders-Sometimes patients also report experiencing symptoms such as muscle and joint pain, migraines, allergic reactions, colon and stomach problems as well as the more common symptoms of IC described above.
Diagnosis is very difficult and must follow several steps:
1)Urine cultures must be negative
2)Rule out other associated disease, bladder cancer, stone disease, anatomic abnormalities
3)cystoscopy-routine cystoscopy in the clinic may not be sufficient to make a diagnosis of IC. It is usually necessary to distend the bladder under general anesthesia in order to see pinpoint hemorrhages on the bladder wall a hallmark of this disease.  It may even be necessary for a biopsy to be taken at that time as well.
4)Diagnostic radiology-IVP, KUB
1)Bladder distention
2)Oral medication-anti-inflammatory drugs,antispasmotics, antihistamines and muscle relaxants.
3)DMSO(Dimethlyl Sulfoxide)-bladder instillation
4)Elmiron-(Sodium Pentosanpolysulfate)
7)Trans- cutaneous nerve stimulation Unit
8)Silver Nitrate
9)Clorpactin WCS-90
10)Self Help- biofeedback
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