Urination Urge

WHEN TO SEE YOUR DOCTOR

* Despite the strong urge, you release a relatively small amount of urine or none at all.

* Frequent urination, a burning sensation, pain or discomfort accompanies your urges to go to the bathroom.

What Your Symptom Is Telling You

The urge to urinate seems as natural as sleepiness or hunger. But sometimes you feel the urge and think you're going to go?yet not much comes out, or the amount doesn't match the urgency. Usually, the reason is that something is impeding the flow or irritating the urinary tract.

In a glitch-free urinary tract, the urge to urinate comes courtesy of your bladder, the hollow, baglike muscle into which your kidneys dump urine. When the bladder fills to the brim, it wants to contract itself to empty. That sends a signal to your brain, giving you the urge to go.

But urinary tract irritants and stimulants can fool your bladder. Alcohol, and caffeine-containing beverages like coffee and Simple stress or anxiety can also jar the neural network into making you think you have to go to the bathroom, says Allen D. Seftel, M.D., an assistant professor of urology at University Hospitals of Cleveland.

Infections also aggravate the urinary tract and are a common cause of this symptom. Whether an infection hits the kidneys, bladder, urethra, vagina or prostate, it either stimulates the production of urine or gives you the sensation that you have to go to the bathroom, explains Dr. Seftel. Infections also can produce a burning sensation when you urinate. A poorly understood infection called interstitial cystitis also causes an almost continual urge to go to the bathroom as well as pain or discomfort.

Constipation can block the flow of urine. "The bladder and bowels are neighbors," he adds. "Sometimes you have the urge and you do have to go, but pressure from the stool obstructs the flow of urine."

Kidney stones, bladder stones and enlargement of the prostate can also block the flow of urine along the urinary tract, Dr. Seftel says. The bladder cannot empty completely because of the obstruction, which means it fills more quickly. If these conditions are left untreated, urination becomes more forced and difficult, and incontinence could result.

Symptom Relief

You could give in and go?or try to?every time you feel the calling. But that can be frustrating, not to mention counterproductive, according to Joseph M. Montella, M.D., an assistant professor and director of the Division of Urogynecology in the Department of Obstetrics and Gynecology at Jefferson Medical College of Thomas Jefferson University in Philadelphia. By always urinating as soon as you sense the slightest desire, you actually can shrink the size of your bladder, he says, and you'll end up having the urges even more. Here are a few hints that might prove helpful.

When the urge hits, relax. As paradoxical as it sounds, what you don't want to do when you have a knee-banging urge to urinate is tense up. Relax instead. "I know it seems counterintuitive," says Dr. Baumann, "but since the bladder is a muscle that contracts to empty, you want to relax it to overcome the urge." When the urge hits, sit down, close your eyes and take some deep breaths. Be careful not to relax the pelvic muscles responsible for preventing a spill. Or try any of your favorite relaxation techniques. "It often seems to calm the urge in many of my patients," Dr. Baumann says. This technique works especially well when stress is responsible for the urge.

Tense your sphincter. The same signal responsible for squeezing your pelvic sphincter muscles also tells your bladder to relax, Dr. Montella says. In about a minute, the urge to urinate will subside?temporarily, of course.

Keep a diary. By keeping a record of what you eat and when you urinate, you may be able to spot the food and drinks that provoke the urge. Then you can reduce or even eliminate those irritants from your diet.

Fight off infections. Taking antibiotics for a couple of days will eliminate any infections that might be causing your urges to rush to the bathroom. Tell your doctor about your problem and ask for a checkup and urine test.

See also Incontinence