Dr. Huntley's
Diagnosis
Checklist
Have a symptom?
See what questions
a doctor would ask.
See what questions
a doctor would ask.
Urinary frequency refers to increased incidence of the urge to void without an increase in the total volume of urine produced. Usually resulting from decreased bladder capacity, urinary frequency is a cardinal sign of urinary tract infection (UTI). (See Associated disorder: Urinary tract infection, page 666.) However, it can also stem from another urologic disorder, neurologic dysfunction, or pressure on the bladder from a nearby tumor or from organ enlargement (as with pregnancy).
Ask the patient how many times per day he voids. How does this compare to his previous pattern of voiding? Ask about the onset and duration of the abnormal frequency and about any associated urinary signs or symptoms, such as dysuria, urgency, incontinence, hematuria, discharge, or lower abdominal pain with urination.
Ask also about neurologic symptoms, such as muscle weakness, numbness, or tingling. Explore his medical history for UTI, other urologic problems or recent urologic procedures, and neurologic disorders. With a male patient, ask about a history of prostatic enlargement. If the patient is a female of childbearing age, ask whether she is or could be pregnant.
Obtain a clean-catch midstream specimen for urinalysis and culture and sensitivity tests. Then palpate the patient’s suprapubic area, abdomen, and flanks, noting any tenderness. Examine his urethral meatus for redness, discharge, or swelling. In a male patient, the physician may palpate the prostate gland.
If the patient’s medical history reveals symptoms or a history of neurologic disorders, perform a neurologic assessment.
With benign prostatis hyperplasia (BPH), prostatic enlargement causes urinary frequency, along with nocturia and possibly incontinence and hematuria. Initial effects are reduced caliber and force of the urine stream, urinary hesitancy and tenesmus, inability to stop the urine stream, a feeling of incomplete voiding, and occasionally urine retention. Assessment reveals bladder distention.
Bladder irritation may lead to urinary frequency and urgency, dysuria, terminal hematuria, and suprapubic pain from bladder spasms. The patient may have overflow incontinence if the calculus lodges in the bladder neck. Greatest discomfort usually occurs at the end of micturition if the stone lodges in the bladder neck. This may also cause overflow incontinence and referred pain to the lower back or heel.
Urinary frequency, urgency, dribbling, and nocturia may develop from bladder irritation; however, the first sign of bladder cancer commonly is gross, painless, intermittent hematuria (usually with clots). Patients with invasive lesions commonly have suprapubic or pelvic pain from bladder spasms.
Urinary frequency, urgency, and incontinence are common urologic findings in patients with multiple sclerosis. Typically, visual problems (such as diplopia and blurred vision) and sensory impairment (such as paresthesia) are the earliest symptoms. Other findings may include constipation, muscle weakness, paralysis, spasticity, hyperreflexia, intention tremor, ataxic gait, dysarthria, impotence, and emotional lability.
In advanced stages of prostate cancer, urinary frequency may occur, along with hesitancy, dribbling, nocturia, dysuria, bladder distention, perineal pain, constipation, and a hard, irregularly shaped prostate.
Acute prostatitis commonly produces urinary frequency, along with urgency, dysuria, nocturia, and purulent urethral discharge. Other findings include fever, chills, low back pain, myalgia, arthralgia, and perineal fullness. The prostate may be tense, boggy, tender, and warm. Signs and symptoms of chronic prostatitis are usually the same as those of the acute form, but to a lesser degree. The patient may also experience pain on ejaculation.
The pressure exerted by a rectal tumor on the bladder may cause urinary frequency. Early findings include changed bowel habits, commonly starting with an urgent need to defecate on arising or obstipation alternating with diarrhea; blood or mucus in the stool; and a sense of incomplete evacuation.
Reiter’s syndrome is a self-limiting syndrome in which urinary frequency occurs with symptoms of acute urethritis 1 to 2 weeks after sexual contact. Other symptoms include asymmetrical arthritis of knees, ankles, and metatarsophalangeal joints; unilateral or bilateral conjunctivitis; and small painless ulcers on the mouth, tongue, glans penis, palms of the hands, and soles of the feet.
A tumor in the female reproductive tract may compress the bladder, causing urinary frequency. Other findings vary but may include abdominal distention, menstrual disturbances, vaginal bleeding, weight loss, pelvic pain, and fatigue.
Incomplete spinal cord transection results in urinary frequency, continuous overflow, dribbling, urgency when voluntary control of sphincter function weakens, urinary hesitancy, and bladder distention. Other effects occur below the level of the lesion and include weakness, paralysis, sensory disturbances, hyperreflexia, and impotence.
Bladder decompensation produces urinary frequency, along with urgency and nocturia. Early signs include hesitancy, tenesmus, and reduced caliber and force of the urine stream. Eventually, overflow incontinence may occur. Urinoma and urosepsis may develop.
UTI is a common cause of urinary frequency. It may also produce urgency, dysuria, hematuria, cloudy urine and, in males, urethral discharge. The patient may report bladder spasms or a feeling of warmth during urination and a fever.
Diuretics, which include caffeine, reduce the body’s total volume of water and salt by increasing urine excretion. Excessive intake of coffee, tea, and other caffeinated beverages leads to urinary frequency.
Radiation therapy may cause bladder inflammation, leading to urinary frequency.
Prepare the patient for diagnostic tests, such as urinalysis, culture and sensitivity tests, imaging tests, ultrasonography, cystoscopy, cystometry, postvoid residual tests, and a complete neurologic workup. If the patient’s mobility is impaired, keep a bedpan or commode near his bed. Accurately document the patient’s daily intake and output amounts.
UTI is a common cause of urinary frequency in children, especially girls. Congenital anomalies that can cause UTI include a duplicated ureter, congenital bladder diverticulum, and an ectopic ureteral orifice.
Men older than age 50 are prone to frequent non–sex-related UTIs. In postmenopausal women, decreased estrogen levels cause urinary frequency, urgency, and nocturia.
Instruct sexually active patients in safer sex practices. Advise girls to clean the genital area from front to back to reduce contamination by Escherichia coli. Women should increase fluid intake, especially water, void frequently throughout the day, and clean themselves in the same manner as girls.
Read excerpts from these other book chapters related to Weak urination:
Copyright Details: Signs & Symptoms: A 2-in-1 Reference for Nurses, Copyright © 2008 Williams & Wilkins.
|
More About This Book:
Title: Signs & Symptoms: A 2-in-1 Reference for Nurses Authors: Springhouse Publisher: Lippincott Williams & Wilkins Copyright: 2007 ISBN: 1-58255-318-1 
|
|
What do you think about the features of this website? Take our user survey and have your say:
Next articles:
Tools & Services:
Medical Articles:
Search Specialists by State and City
By using this site you agree to our Terms of Use. Information provided on this site is for informational purposes only; it is not intended as a substitute for advice from your own medical team. The information on this site is not to be used for diagnosing or treating any health concerns you may have - please contact your physician or health care professional for all your medical needs. Please see our Terms of Use.
Copyright © 2010 Health Grades Inc. All rights reserved. Last Update: 9 February, 2010 (1:01)
