Q: My 68 years old wife has a problem of frequent urination. She feels severe pain and burning sensation while urinating and takes long to urinate. All pathological tests are normal. She has been operated for urethral stenosis last year. The doctor has told us that her bladder size is small and therefore, she would have to bear the problem of frequent urination for the rest of her life. She is taking Urivoid twice daily and Veltam 0.2 mg daily for the last 4 months. Is there any other way or medication for better quality of life?

A:Frequent urination results from either increased urine formation or a small bladder capacity. Increased urine formation occurs with high fluid intake, diabetes or some pathological conditions of kidney reducing its concentrating ability. Bladder capacity could be reduced temporarily, as with acute urine infections, but returns to normal as infection settles. Long term increased urine frequency could be due to a large bladder residual with reduced effective bladder capacity. True anatomical reduction in bladder capacity may result from chronic infections, thickened bladder with some neurogenic conditions, a stone in the bladder or some bladder cancers. Chronic infections and urethral stenosis in post-menopausal females, as your wife, could be a result of perineal changes due to lack of estrogens. She needs a full gynaecological examination and urological evaluation before a logical conclusion may be drawn. Presently the diagnosis of urethral stenosis does not go with the line of medications she is being given. Her present medications are usually prescribed to handle a bladder with poor contractility.