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ULY CLINIC

19 Septemba 2025, 04:40:39

Urinary frequency

Urinary frequency refers to the increased incidence of the urge to void without a proportional increase in total urine volume. It is a common symptom in urinary tract infections (UTIs) but may also result from urologic, neurologic, or obstructive conditions affecting bladder function. Compression from nearby organs or tumors (e.g., reproductive tract, rectal tumors, pregnancy) may also produce frequency.

Pathophysiology

Decreased bladder capacity – from inflammation, irritation, or obstruction.
Bladder overactivity – due to neurologic dysfunction or infection.
Mechanical compression – from tumors or organ enlargement reducing effective bladder volume.
Prostatic obstruction – in men, enlargement of the prostate increases bladder outlet resistance.
Iatrogenic or pharmacologic causes – diuretics or bladder irritants.

History and Physical Examination

History

Frequency pattern: Number of voids per day, comparison with baseline.
Onset and duration: Acute vs. chronic.
Associated urinary symptoms: Dysuria, urgency, incontinence, hematuria, urethral discharge, suprapubic pain.
Neurologic symptoms: Weakness, numbness, tingling, spinal cord injury history.
Medical history: Previous UTIs, urologic disorders, prostate disease, recent instrumentation.
Female-specific factors: Pregnancy, reproductive tract pathology.

Physical Examination

Abdominal and suprapubic palpation: Assess for tenderness, bladder distention.
Flank palpation: Evaluate for renal tenderness.
Urethral inspection: Redness, swelling, discharge.
Male-specific: Prostate palpation (note size, consistency, tenderness).
Neurologic evaluation: If history suggests spinal cord or neurologic involvement.

Medical causes

Cause	Key Features	Associated Findings	Pathophysiology	Clinical Notes
Benign prostatic hyperplasia (BPH)	Urinary frequency, nocturia	Hesitancy, weak stream, incomplete voiding, occasional retention	Enlarged prostate → bladder outlet obstruction	Bladder may be distended; risk of chronic retention
Bladder calculus	Urinary frequency, urgency, dysuria	Terminal hematuria, suprapubic pain, possible overflow incontinence	Stone irritates bladder wall or obstructs bladder neck	Pain often at end of micturition; may radiate to back/heel
Prostate cancer (advanced)	Urinary frequency	Hesitancy, dribbling, nocturia, bladder distention, perineal pain, constipation	Tumor compresses bladder outlet	Prostate irregular, hard on palpation
Prostatitis (acute)	Urinary frequency, urgency, dysuria	Nocturia, fever, chills, low back pain, perineal fullness	Bacterial infection/inflammation of prostate	Prostate tense, boggy, tender; avoid prostate massage
Prostatitis (chronic)	Persistent urinary frequency	Mild dysuria, ejaculatory pain, urinary disturbances	Low-grade chronic inflammation	Often less severe than acute
Rectal tumor	Urinary frequency	Altered bowel habits, rectal bleeding, mucus, incomplete evacuation	Bladder compression by rectal mass	Early bowel changes may precede urinary symptoms
Reiter’s syndrome	Urinary frequency 1–2 weeks post-infection	Conjunctivitis, arthritis, oral/genital ulcers	Autoimmune reaction after infection	Self-limiting; symptomatic treatment
Reproductive tract tumor (female)	Urinary frequency	Abdominal distention, menstrual irregularities, pelvic pain, weight loss	Bladder compression by mass	Early detection important; varies by tumor type
Spinal cord lesion	Urinary frequency, dribbling, overflow	Weakness, paralysis, sensory disturbances, hyperreflexia	Loss of voluntary sphincter control	Incomplete cord transection → neurologic bladder
Urethral stricture	Urinary frequency, urgency	Hesitancy, reduced stream, tenesmus	Bladder decompensation from obstruction	May progress to overflow incontinence or urosepsis
Urinary tract infection (UTI)	Urinary frequency	Urgency, dysuria, hematuria, cloudy urine, suprapubic pain	Infection/inflammation of urethra, bladder, or kidney	Young adult males: often STI-related

Other causes

Diuretics (caffeine, medications) – increase urine production → frequency.
Radiation therapy – bladder inflammation can produce frequency.

Special considerations

Prepare for urinalysis, culture, imaging, cystoscopy, cystometry, postvoid residual measurement, and neurologic evaluation if indicated.
For immobile patients, keep bedpans or commodes accessible.
Document accurate fluid intake and urinary output.

Patient counseling

Maintain proper genital hygiene.
Encourage safe sex practices.
Increase fluid intake unless contraindicated.
Teach Kegel exercises to strengthen pelvic floor.
Explain the importance of follow-up for persistent or recurrent symptoms.

Pediatric pointers

UTIs are a common cause of urinary frequency in children, especially girls.
Evaluate for congenital anomalies: duplicated ureters, bladder diverticulum, ectopic ureteral orifice.

Geriatric pointers

Men >50 years: frequent non–sex-related UTIs.
Postmenopausal women: decreased estrogen → frequency, urgency, nocturia.

References

Buttaro TM, Tybulski J, Bailey PP, Sandberg-Cook J. Primary Care: A Collaborative Practice. 2nd ed. St. Louis, MO: Mosby Elsevier; 2008. p. 444–447.
Lehne RA. Pharmacology for Nursing Care. 7th ed. St. Louis, MO: Saunders Elsevier; 2010.
Schuiling KD. Women’s Gynecologic Health. Burlington, MA: Jones & Bartlett Learning; 2013.
Nickel JC. Benign prostatic hyperplasia: Clinical update. Can J Urol. 2002;9(Suppl 1):S4–S12.
Stamm WE, Hooton TM. Management of urinary tract infections in adults. N Engl J Med. 1993;329:1328–1334.
Abrams P, Andersson KE. Lower urinary tract function and dysfunction. Neurourol Urodyn. 2007;26:740–742.