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What is the reason for frequent urination?

Mahendra Bhandari
Professor of Urology, Director Clinical Research,
Henry Ford Hospital,
Detroit, USA

Q: I am 33 years old and have a frequent urination problem. My bladder volume is normal. I am taking Urimax 0.4mg and Roliten OD 4mg twice daily. I have kidney stones of 5mm and 10mm in both kidneys. If I drink more water, the frequency of urine increases. My 24 hours urine output is 1300 ml. My pre void is 374 cc and post void is 88 cc. What should I do for kidney stones? My stone type may be calcium oxalate because in my 24-hour urine, oxalate and calcium were more than normal. When I pass urine, my stream is very poor, but I don't have burning sensation. The urine volume is usually 20ml, 70ml or 130ml. My bladder diary for today [24 hours] is – 7 am, 8am, 9:30 am, 2:15 pm, 2:40 pm, 4:30 pm, 5 pm, 6 pm, 7:30 pm, 9:30 pm, 10:30pm, 11:35 pm, 3:35 am, 4:40 am, 7:40 am. My night time frequency is 2-5 times. The doctor said that I have overactive bladder and problem with the prostate. Can Urimax and Roliten OD cure these, or do I need surgery? I take more tea, will that cause any problem? I am facing this problem for the last 20 years. The CMG test says I have an overactive bladder, obstruction due to prostate and kidney stones. What medicine should I take for kidney stones? My doctor told me to take Losar-H. What medicines should I take for frequent urination?

A:I am sorry to learn that you are suffering with urinary problem for the past 20 years. However, the good news is that it is not a serious problem and it is unlikely to cause any permanent drainage. I have carefully gone through your notes and observed that your frequency is really bothersome and some thing is to be done to improve the same. Your residual urine and bladder capacity are normal. The following guidelines should assist you -1. Cut on your fluids to maintain your output to 1-1.2 litres. I know you would have been advised to increase your fluid uptake for your stone disease and hence you need to keep a balance.2. You have done well by reducing your tea/coffee intake. It is bound to help you reduce your frequency to some extent.3. Taking Hydrochlorthiazide is also worsening your frequency and in your case if it is o.k. with your doctor, I would recommend stopping the same.4. If your urine flow is good with Urimax and Roliten, you could continue the same. 5. There are good medicines as Tropan to relax bladder and to reduce frequency. But since these drugs need constant monitoring of the doses it would be better you take them under the advice of your local urologist.6. Do not get any surgery done on your prostate as the frequency of urination is going to be worse once the prostate is out. Now we can manage majority of prostate problems with the drugs alone. 7. I am not impressed with the size of stones you mention particularly if they are on ultrasound. It is better your urologist investigates you to establish whether you have stone disease or not.