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Forum Name: Urology Topics

Question: Constant urge to urinate- no other pain!


 jcountry86 - Wed Dec 16, 2009 7:44 am

I am a 23 yr old female and for the last 5 months I have had a constant urge to urinate. I have had no other pain. I went to a urologist who said that a yeast infection I had got into my bladder, but the medication he gave me did not help. He the did a scope and said everything looked normal and dismissed my problem. I went to a gynecologist who diagnosed me with bacterial vaginitis and gave me a Metro gel for my vagina. This did not help either. I am very stressed in my life right now. Could this have something to do with it? I have no other pain really, except a small sharp twinge every once in a while from my urethra I think. The urge to urinate fluctuates day to day, but is usually always noticeable and often very bad at night, interrupting my sleep several times. Sexual activity can make the urge to urinate worse the next day, and a hard bowel movement can make it worse too. Since I know that my urine is normal, there is no UTI, I really can't figure out what is wrong! Please help me!
 Dr.M.Aroon kamath - Mon Dec 28, 2009 5:14 am

User avatar Hi
There can be a number of conditions that cause urinary frequency.

a) Urinary tract infections: Dipstick test is the generally accepted screening test for UTI. But, Mycoplasma and ureaplasma are not always picked up on standard dip test screens.

Although, UTIs are usually diagnosed by urinary cultures,sometimes it is probable that the organism that is causing the infection may be grown in smaller numbers (Low-count bacteriuria) and thus dismissed as a contaminant!

As you are a young woman, it may be worth remembering that Staphylococcus saprophyticus is a common cause of urinary tract infections (UTIs) in young and middle-aged women(next only to E.Coli).Staphylococcus saprophyticus is a coagulase-negative staphylococcus associated primarily with community-acquired lower urinary tract infection (UTI).

b) One may also need to keep in mind the possibility of the Traumatic cystitis(due to sexual intercourse).

c) 'Overactive bladder' is not uncommon in women. The cause is unknown. It causes bladder contractions that occur on their own without the stimulation of an actually full bladder. Most of the time one has urgency symptoms but not too much of pain. Nocturnal frequency is common but the frequency is less compared to interstitial cystitis. Urinary cultures are usually negative.

d) Bowel spasticity or Ovarian cysts are known to cause a feeling of bladder fullness and urgency.

e) Urethral syndrome can cause a urethral urgency ,but, the sensation of full bladder may be notably lacking.

In your case, 'Overactive bladder' appears to be the more likely diagnosis, perhaps made worse by mental stress.

Best wishes!

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