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Urgency and Frequency

I have a similar problem to the one posted by Jbrooks4002 on March 06, 2008. A little more than a year ago, I started noticing I couldn't wait to urinate when I had to go. I never had leaking, but it was a severely urgent sensation. A week or two after that started, I was pretty bad. I was going every hour or more, even though my urine was clear and not much came out. I saw the first doctor and he gave me antibiotics. My urine test showed negative for UTI, but he figured he would be safe. After that failed, I went to my second urologist. He listed to my symptoms and started prescribing medications. He did a voiding ultrasound, but it seemed to show nothing. We tried Cipro, Detrol, and Enablex. All seemed to help a little, but nothing really fixed the problem. Each medication was taken for a couple months to see if they worked. The last medication, Sanctura, seemed to work the best. I stuck with that for about 6 months, as it made life manageable. I did a voiding rate test during that time (pee into cup device and measure flow) and it looked ok. The whole time my voiding seemed slower and with less volume in my own opinion. I ended up seeing a 3rd urologist due to a move. He was shocked that I hadn't had more tests. He first did a cyctoscopy (camera into bladder by way of catheter). He said he could see that the pelvic floor seemed tight, but I was free from lesions or other stuff. Next I had the videourodynamic study (aka the most painful thing a man can endure). It showed high pressure in the bladder when voiding. Also, my bladder muscles seemed tense. After that came a full pelvic CT scan. That confirmed that my bladder neck was tense and tight. The doctor was pretty sure that this all meant I wasn't voiding properly and that it was causing my problems. I have always passed the voiding ultrasound, so I don't know how that could be. He prescribed flomax, and I have been on it ever since. Flomax helps a little, but I still have urgency. Also, like Jbrooks, my symptoms are amplified after a bowel movement. No one can explain what is going on. I also noticed that when my symptoms are the worst, my urine is almost clear like water and I pass a decent amount of urine. It has a peculiar smell as well. So, here I am with no answers. They even sent me to a Neurologist who said my hyperactivity in the knees may be related. Can anyone help me?

Also, possibly related things that are happening to my body: hives after scratching a lot, twitch in eyes or arm muscles once in a while, and bowel movements 2-3 times a day compared to 1 time a day that I was used to (may be related to medication).


This discussion is related to Urgency/Frequency/Weak Flow.
3 Responses
Avatar universal
No one can help me?
351246 tn?1379685732
MEDICAL PROFESSIONAL
Hi
Thanks for writing to the forum!
Your symptoms could be due to over active bladder. “In people with an overactive bladder (OAB), the layered, smooth muscle that surrounds the bladder (detrusor muscle) contracts spastically, sometimes without a known cause, which results in sustained, high bladder pressure and the urgent need to urinate (called urgency).”
“A malfunctioning detrusor muscle causes overactive bladder. Identifiable underlying causes include the following:Nerve damage caused by abdominal trauma, pelvic trauma, or surgery
Bladder stones
Drug side effects
Neurological disease (e.g., multiple sclerosis, Parkinson's disease, stroke, spinal cord lesions)
Bladder cancer or prostate cancer

Other conditions can produce symptoms similar to overactive bladder, including urinary tract infection (UTI) and normal pressure hydrocephalus.


Since you mention very clear urine, I would also look at the possibility od diabetes insipidus. Another associated problem could be diabetes mellitus.

Hope this helps. It is difficult to comment beyond this at this stage. You need a comprehensive investigation taking all these points in consideration. Please discuss this with your doctor and get yourself investigated accordingly. Please let me know if there is any thing else and do keep me posted. Take care!
Refer: http://www.urologychannel.com/bladdercontrol/causes.shtml
Avatar universal
I have discussed OAB many times with all my doctors. My latest doc doesn't believe it could be OAB. He said the only area that was tense in my bladder was the bladder neck. OAB usually does not cause restriction in the urine stream. My urine stream was only normal again after taking flomax. I have taken about every medication out there for OAB and none seemed to really help. Another thing to consider is the fact that I am only 26 and this problem started all of the sudden. My urologist said that a person my age just waking up one day with OAB is highly unlikely. Most of the uncomfortable feelings I have when I have urgency comes from the bladder neck and urethra. I have considered diabetes insipidus, but my doctor said it was very rare. I would have to have something other than DI since my urgency is not always related directly to having a full bladder. Thanks for trying to help, though. I am really lost on this topic. I have researched every known disease and dysfunction.

Also, when I go for a run, my bladder neck feels very irritated.
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