Some Causes of Urinary Frequency
Cause | Suggestive Findings | Diagnostic Approach |
|---|---|---|
Progressive onset of urinary hesitancy, incontinence, poor urine stream, a sensation of incomplete voiding | Rectal examination Ultrasonography Cystometry | |
Urinary incontinence Sensation of vaginal fullness Pain or urinary leakage during sexual intercourse | Pelvic examination Voiding cystourethrography | |
Pregnancy | Third trimester of pregnancy | Clinical evaluation |
Urgency, dysuria, nocturia, purulent urethral discharge with fever, chills, low back pain, myalgia, arthralgia, and perineal fullness Prostate tender to palpation | Rectal examination Culture of secretions after prostatic massage | |
Radiation cystitis | History of radiation therapy of the lower abdomen, prostate, or perineum for treatment of cancer | Clinical evaluation Cystoscopy and biopsy |
Asymmetric arthritis of knees, ankles, and metatarsophalangeal joints Unilateral or bilateral conjunctivitis Small, painless ulcers on the mouth, tongue, glans penis, palms, and soles 1–2 weeks after sexual contact | STI testing | |
Lower-extremity weakness, decreased anal sphincter tone, absent anal wink reflex Loss of sensation at a segmental level Injury usually clinically obvious | MRI of the spine | |
Substances and medications
| Urinary frequency in an otherwise healthy patient | Empiric elimination of offending substance (to confirm that frequency resolves) |
Hesitancy, tenesmus, reduced caliber and force of the urine stream | Urethrography | |
Unintentional passage of urine, particularly when bending, coughing, or sneezing | Cystometry | |
Colicky flank or groin pain | Urinalysis for hematuria Ultrasonography or CT of the kidneys, ureters, and bladder | |
Dysuria and foul-smelling urine, sometimes fever, confusion, and flank pain, particularly in women and girls Dysuria and frequency in young sexually active men (which suggests an STI) | Urinalysis and culture STI testing | |
Bladder detrusor overactivity | Nocturia, urge incontinence, weak urinary stream, and sometimes urinary retention | Cystometry |
STI = sexually transmitted infection. | ||