Urinary urgency: Difference between revisions

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{{Infobox_Disease |
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
  Name        = Urgency of urination |
{{SI}}
  ICD10      =  |
{{CMG}} {{AE}} {{LRO}}
  ICD9        = {{ICD9|788.63}} |
}}
{{Search infobox}}
{{SCC}}


{{Editor Join}}
{{SK}} urgency


==Overview==
==Overview==
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'''Urinary urgency''' is a sudden, compelling urge to urinate. It is often, though not necessarily, associated with [[interstitial cystitis]], urge [[urinary incontinence]], [[polyuria]] and [[nocturia]].  Urinary urgency often occurs as a result of irritation and/or inflammation of the [[urothelium]] (aka the bladder wall). In interstitial cystitis, urinary frequency and urgency are the hallmark symptoms, in addition to nocturia and dyspareunia. In many cases, however, these symptoms are often exacerbated by the consumption of foods and/or beverages that are high in acid and caffeine, particularly coffees, regular teas, green teas, sodas, diet sodas and, surprisingly, fruit juices. Cranberry juice, for example, often causes extreme urgency in patients with a damaged bladder lining due to its high acid content.
'''Urinary urgency''' is a sudden, compelling urge to urinate. It is often, though not necessarily, associated with [[interstitial cystitis]], urge [[urinary incontinence]], [[polyuria]] and [[nocturia]].  Urinary urgency often occurs as a result of irritation and/or inflammation of the [[urothelium]] (aka the bladder wall). In interstitial cystitis, urinary frequency and urgency are the hallmark symptoms, in addition to nocturia and dyspareunia. In many cases, however, these symptoms are often exacerbated by the consumption of foods and/or beverages that are high in acid and caffeine, particularly coffees, regular teas, green teas, sodas, diet sodas and, surprisingly, fruit juices. Cranberry juice, for example, often causes extreme urgency in patients with a damaged bladder lining due to its high acid content.


==Differential diagnosis of causes of urgency==
==Causes==
===Incomplete voiding===
<div style="-webkit-user-select: none;">
===[[Polyuria]]===
===Life Threatening Causes===
===Reduced bladder capacity===
*[[Appendicitis]]
===Urinary tract obstruction===
*[[Congestive heart failure]]
*Bladder neck obstruction
*[[Kidney cancer]]
*[[Prostatic hypertrophy]]
*[[Liver failure]]
*[[Prostatitis]]
*[[Occupational cancer ]]
*Median bar hypertrophy
*[[Pelvic tumors]]
*[[Urethral stricture]]
*[[Pheochromocytoma]]
*[[Squamous cell carcinoma of lung ]]
*[[Stroke ]]
*[[Urethral cancer]]
*[[Urinary tract neoplasm ]]
 
===Common Causes===
* [[Acromegaly]]
* [[Addison's disease]]
* behavioral or [[psychogenic]] water drinking
* [[Congestive heart failure]]
* [[Cushing's syndrome]]
* [[Diabetes insipidus]]
* [[Diabetes mellitus]]
* [[Drugs]]- [[BCG vaccine]]
* Emphysematous [[cystitis]]
* [[Enlarged prostate]] from disease or [[benign prostatic hyperplasia]]
* [[Fanconi syndrome]]/[[renal glycosuria]]
* [[Glomerulonephritis]]
* high doses of [[riboflavin]]
* [[Hyperaldosteronism]]/[[Conn's syndrome]]
* [[Hypercalcaemia]]
* [[Hypercalcemia]] (most commonly from [[cancer]])
* [[Hyperthyroidism]]
* [[Hypokalemia]]
* [[hypopituitarism]]
* [[Interstitial cystitis]]
* [[Interstitial nephritis]]
* [[Intestinal obstruction]]  (occurs after toxins begin to be absorbed from the damaged intestine)
* [[Liver failure]]/ [[cirrhosis]]
* [[Lupus]] or other [[connective tissue]] disease related cystitis
* [[Neurologic]] damage
* Partial obstruction of the [[urinary tract]]
* [[Pheochromocytoma]]
* [[Polycythemia]]
* [[Pregnancy]]
* [[Pyometra]] in certain animals or [[appendicitis]] in humans
* [[Reactive arthritis]]/[[Reiter's syndrome]]
* [[Renal Tubular Acidosis]]
* [[SIADH]]
* Side effect of [[Lithium#Medical use|lithium]] to treat manic disorders see lithium thirst
* [[Sjogren's Syndrome]]
* [[Squamous cell carcinoma]] of [[lung]] (a [[paraneoplastic]] consequence)
* [[Urinary tract infection]] - although it more commonly causes frequent passage of small volumes of urine rather than a large volume
 
===Causes by Organ System===
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Congestive heart failure]],  [[Hypertension-like disorders]],  [[Stroke ]]
|-
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Aminohippurate]],  [[Bendrofluazide]],  [[Bumetanide]],  [[Caffeine]],  [[Canagliflozin]],  [[Cardioquin]],  [[Conivaptan]],  [[Dapagliflozin]],  [[Diuretics]],  [[Empagliflozin]],  [[Frusemide]],  [[Hydrochlorothiazide]],  [[Isosorbide]],  [[Lithium]],  [[Mannitol]],  [[Parasympatholytic drugs]],  [[Quinaglute dura-tabs]],  [[Quinalan]],  [[Quinidex]],  [[Quinidine]],  [[Quinora]],  [[Quin-release]],  [[Riboflavin]],  [[Siadh]],  [[Sorbitol]]
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| [[Sjogren's syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| [[Acromegaly]],  [[Addison's disease]],  [[Cushing's syndrome]],  [[Fanconi syndrome]],  [[Hyperaldosteronism]],  [[Hyperparathyroidism]],  [[Hyperthyroidism]],  [[Hypopituitarism]],  [[Pheochromocytoma]],  [[Polydipsia]]
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| [[Appendicitis]],  [[Constipation]],  [[Diverticulitis]],  [[Hyperglycaemia]],  [[Intestinal obstruction ]],  [[Liver failure]]
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| [[Nephronophthisis type 1]]
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| [[Diabetes insipidus]],  [[Diabetes mellitus]],  [[Diverticulitis]],  [[Hypercalcemia ]],  [[Hyperglycaemia]],  [[Hypokalemia]],  [[Polycythemia]]
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| [[Radiation therapy]]
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| [[Poliomyelitis]],  [[Tabes dorsalis]],  [[Tolvaptan]],  [[Urethra infection]],  [[Urinary tract infection]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| [[Pelvic tumors]],  [[Spinal cord injury]],  [[Spinal cord lesions]]
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| [[Ataxia]],  [[Calcification of basal ganglia ]],  [[Diabetic neuropathy]],  [[Multiple sclerosis]],  [[Nephronophthisis type 1]],  [[Neurogenic bladder]],  [[Neurologic damage]],  [[Pudendal nerve entrapment ]],  [[Spastic paraplegia ]],  [[Stroke ]]
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| [[Diabetes insipidus]],  [[Diabetes mellitus]],  [[Excessive water consumption]],  [[Hypercalcemia ]],  [[Nutrasweet]]
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| [[Pregnancy]],  [[Pyometra ]],  [[Salpingitis]],  [[Spastic pelvic floor syndrome ]],  [[Vaginitis]]
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| [[Bladder cancer]],  [[Occupational cancer ]],  [[Pelvic tumors]],  [[Pheochromocytoma]],  [[Squamous cell carcinoma of lung ]],  [[Urethral cancer]],  [[Urinary tract neoplasm ]]
|-
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
|bgcolor="Beige"| [[Alcohol]],  [[Caffeine]]
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| [[Anxiety]]
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| [[Emphysematous cystitis]],  [[Squamous cell carcinoma of lung ]]
|-
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
|bgcolor="Beige"| [[Cystitis]],  [[Excessive water consumption]],  [[Glomerulonephritis]],  [[Hyperaldosteronism]],  [[Hypokalemia]],  [[Kidney cancer]],  [[Kidney stones ]],  [[Medullary cystic kidney disease type 1]],  [[Medullary cystic kidney disease type 2]],  [[Polydipsia]],  [[Pyelonephritis ]],  [[Renal calculus]],  [[Renal tubular acidosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| [[Reiter's syndrome]],  [[Sicca syndrome]],  [[Sjogren's syndrome]],  [[Systemic lupus erythematosus]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| [[Hemorrhoids]],  [[Spinal cord injury]],  [[Spinal cord lesions]]
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| [[Acute bacterial prostatitis]],  [[Benign prostate hyperplasia ]],  [[Bladder calculi]],  [[Bladder cancer]],  [[Bladder distention ]],  [[Bladder irritation]],  [[Bladder neck obstruction]],  [[Bladder outflow obstruction]],  [[Blocked urine flow]],  [[Chronic interstitial cystitis ]],  [[Detrusor instability]],  [[Enlarged prostate ]],  [[Incontinence ]],  [[Interstitial cystitis ]],  [[Interstitial nephritis]],  [[Median bar hypertrophy]],  [[Overactive bladder syndrome]],  [[Partial obstruction of the urinary tract]],  [[Prostatic hypertrophy]],  [[Prostatitis]],  [[Urethra infection]],  [[Urethral cancer]],  [[Urethral stricture]],  [[Urge incontinence ]],  [[Urinary tract infection]],  [[Urinary tract neoplasm ]]
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
|-
|}
 
===Causes in Alphabetical Order===
{{columns-list|
*[[Acromegaly]]
*[[Acute bacterial prostatitis]]
*[[Addison's disease]]
*[[Alcohol]]
*[[Aminohippurate]]
*[[Anxiety]]
*[[Appendicitis]]
*[[Ataxia]]
*[[Bendrofluazide]]
*[[Benign prostate hyperplasia ]]
*[[Bladder calculi]]
*[[Bladder calculi]]
===Neurogenic bladder===
*[[Bladder cancer]]
*[[Bladder distention ]]
*[[Bladder irritation]]
*[[Bladder neck obstruction]]
*[[Bladder outflow obstruction]]
*[[Blocked urine flow]]
*[[Bumetanide]]
*[[Caffeine]]
*[[Calcification of basal ganglia ]]
*[[Canagliflozin]]
*[[Cardioquin]]
*[[Chronic interstitial cystitis ]]
*[[Congestive heart failure]]
*[[Conivaptan]]
*[[Constipation]]
*[[Cushing's syndrome]]
*[[Cystitis]]
*[[Dapagliflozin]]
*[[Detrusor instability]]
*[[Diabetes insipidus]]
*[[Diabetes mellitus]]
*[[Diabetic neuropathy]]
*[[Diuretics]]
*[[Diverticulitis]]
*[[Empagliflozin]]
*[[Emphysematous cystitis]]
*[[Enlarged prostate ]]
*[[Excessive water consumption]]
*[[Fanconi syndrome]]
*[[Frusemide]]
*[[Glomerulonephritis]]
*[[Hemorrhoids]]
*[[Hydrochlorothiazide]]
*[[Hyperaldosteronism]]
*[[Hypercalcemia ]]
*[[Hyperglycaemia]]
*[[Hyperparathyroidism]]
*[[Hypertension-like disorders]]
*[[Hyperthyroidism]]
*[[Hypokalemia]]
*[[Hypopituitarism]]
*[[Incontinence ]]
*[[Interstitial cystitis ]]
*[[Interstitial nephritis]]
*[[Intestinal obstruction ]]
*[[Isosorbide]]
*[[Kidney cancer]]
*[[Kidney stones ]]
*[[Lithium]]
*[[Liver failure]]
*[[Mannitol]]
*[[Median bar hypertrophy]]
*[[Medullary cystic kidney disease type 1]]
*[[Medullary cystic kidney disease type 2]]
*[[Multiple sclerosis]]
*[[Nephronophthisis type 1]]
*[[Neurogenic bladder]]
*[[Neurologic damage]]
*[[Nutrasweet]]
*[[Occupational cancer ]]
*[[Overactive bladder syndrome]]
*[[Parasympatholytic drugs]]
*[[Partial obstruction of the urinary tract]]
*[[Pelvic tumors]]
*[[Pheochromocytoma]]
*[[Poliomyelitis]]
*[[Poliomyelitis]]
*[[Parasympatholytic]] drugs
*[[Polycythemia]]
*[[Tabes dorsalis]]
*[[Polydipsia]]
*[[Multiple sclerosis]]
*[[Pregnancy]]
*Spinal cord lesions
*[[Prostatic hypertrophy]]
*[[Diabetic neuropathy]]
===Irritative lesions of the urinary tract===
*[[Urinary tract infection]]
*[[Prostatitis]]
*[[Prostatitis]]
*[[Pudendal nerve entrapment ]]
*[[Pyelonephritis ]]
*[[Pyometra ]]
*[[Quinaglute dura-tabs]]
*[[Quinalan]]
*[[Quinidex]]
*[[Quinidine]]
*[[Quinora]]
*[[Quin-release]]
*[[Radiation therapy]]
*[[Reiter's syndrome]]
*[[Renal calculus]]
*[[Renal calculus]]
*[[Bladder cancer]]
*[[Renal tubular acidosis]]
*[[Kidney cancer]]
*[[Riboflavin]]
*Ureter [[cancer]]
*[[Salpingitis]]
*[[Siadh]]
*[[Sicca syndrome]]
*[[Sjogren's syndrome]]
*[[Sorbitol]]
*[[Spastic paraplegia ]]
*[[Spastic pelvic floor syndrome ]]
*[[Spinal cord injury]]
*[[Spinal cord lesions]]
*[[Squamous cell carcinoma of lung ]]
*[[Stroke ]]
*[[Systemic lupus erythematosus]]
*[[Tabes dorsalis]]
*[[Tolvaptan]]
*[[Urethra infection]]
*[[Urethral cancer]]
*[[Urethral cancer]]
 
*[[Urethral stricture]]
===Pelvic inflammation===
*[[Urge incontinence ]]
*[[Urinary tract infection]]
*[[Urinary tract neoplasm ]]
*[[Urine leakage]]
*[[Vaginitis]]
*[[Vaginitis]]
*[[Hemorrhoids]]
}}
*[[Diverticulitis]]
</div>
*[[Appendicitis]]
*[[Salpingitis]]


== Support Resource ==
== Support Resource ==
Line 59: Line 312:
*[[Polyuria]]
*[[Polyuria]]
*[[Urinary incontinence#Urge incontinence]]
*[[Urinary incontinence#Urge incontinence]]
*[http://www.webmd.com/content/article/108/109010 Research in Acupuncture and Urinary Urgency]
*http://www.nlm.nih.gov/medlineplus/ency/article/003140.htm
 
== External links ==
* http://www.medterms.com/script/main/art.asp?articlekey=18379
* http://www.wrongdiagnosis.com/sym/urinary_urgency.htm
* http://www.shands.org/health/information/article/003140.htm


== References ==
== References ==
Line 70: Line 318:


{{Symptoms and signs}}
{{Symptoms and signs}}
{{SIB}}
 




Latest revision as of 23:14, 10 January 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S.

Synonyms and keywords: urgency

Overview

Urinary urgency is a sudden, compelling urge to urinate. It is often, though not necessarily, associated with interstitial cystitis, urge urinary incontinence, polyuria and nocturia. Urinary urgency often occurs as a result of irritation and/or inflammation of the urothelium (aka the bladder wall). In interstitial cystitis, urinary frequency and urgency are the hallmark symptoms, in addition to nocturia and dyspareunia. In many cases, however, these symptoms are often exacerbated by the consumption of foods and/or beverages that are high in acid and caffeine, particularly coffees, regular teas, green teas, sodas, diet sodas and, surprisingly, fruit juices. Cranberry juice, for example, often causes extreme urgency in patients with a damaged bladder lining due to its high acid content.

Causes

Life Threatening Causes

Common Causes

Causes by Organ System

Cardiovascular Congestive heart failure, Hypertension-like disorders, Stroke
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Aminohippurate, Bendrofluazide, Bumetanide, Caffeine, Canagliflozin, Cardioquin, Conivaptan, Dapagliflozin, Diuretics, Empagliflozin, Frusemide, Hydrochlorothiazide, Isosorbide, Lithium, Mannitol, Parasympatholytic drugs, Quinaglute dura-tabs, Quinalan, Quinidex, Quinidine, Quinora, Quin-release, Riboflavin, Siadh, Sorbitol
Ear Nose Throat Sjogren's syndrome
Endocrine Acromegaly, Addison's disease, Cushing's syndrome, Fanconi syndrome, Hyperaldosteronism, Hyperparathyroidism, Hyperthyroidism, Hypopituitarism, Pheochromocytoma, Polydipsia
Environmental No underlying causes
Gastroenterologic Appendicitis, Constipation, Diverticulitis, Hyperglycaemia, Intestinal obstruction , Liver failure
Genetic Nephronophthisis type 1
Hematologic Diabetes insipidus, Diabetes mellitus, Diverticulitis, Hypercalcemia , Hyperglycaemia, Hypokalemia, Polycythemia
Iatrogenic Radiation therapy
Infectious Disease Poliomyelitis, Tabes dorsalis, Tolvaptan, Urethra infection, Urinary tract infection
Musculoskeletal/Orthopedic Pelvic tumors, Spinal cord injury, Spinal cord lesions
Neurologic Ataxia, Calcification of basal ganglia , Diabetic neuropathy, Multiple sclerosis, Nephronophthisis type 1, Neurogenic bladder, Neurologic damage, Pudendal nerve entrapment , Spastic paraplegia , Stroke
Nutritional/Metabolic Diabetes insipidus, Diabetes mellitus, Excessive water consumption, Hypercalcemia , Nutrasweet
Obstetric/Gynecologic Pregnancy, Pyometra , Salpingitis, Spastic pelvic floor syndrome , Vaginitis
Oncologic Bladder cancer, Occupational cancer , Pelvic tumors, Pheochromocytoma, Squamous cell carcinoma of lung , Urethral cancer, Urinary tract neoplasm 
Ophthalmologic No underlying causes
Overdose/Toxicity Alcohol, Caffeine
Psychiatric Anxiety
Pulmonary Emphysematous cystitis, Squamous cell carcinoma of lung 
Renal/Electrolyte Cystitis, Excessive water consumption, Glomerulonephritis, Hyperaldosteronism, Hypokalemia, Kidney cancer, Kidney stones , Medullary cystic kidney disease type 1, Medullary cystic kidney disease type 2, Polydipsia, Pyelonephritis , Renal calculus, Renal tubular acidosis
Rheumatology/Immunology/Allergy Reiter's syndrome, Sicca syndrome, Sjogren's syndrome, Systemic lupus erythematosus
Sexual No underlying causes
Trauma Hemorrhoids, Spinal cord injury, Spinal cord lesions
Urologic Acute bacterial prostatitis, Benign prostate hyperplasia , Bladder calculi, Bladder cancer, Bladder distention , Bladder irritation, Bladder neck obstruction, Bladder outflow obstruction, Blocked urine flow, Chronic interstitial cystitis , Detrusor instability, Enlarged prostate , Incontinence , Interstitial cystitis , Interstitial nephritis, Median bar hypertrophy, Overactive bladder syndrome, Partial obstruction of the urinary tract, Prostatic hypertrophy, Prostatitis, Urethra infection, Urethral cancer, Urethral stricture, Urge incontinence , Urinary tract infection, Urinary tract neoplasm 
Miscellaneous No underlying causes

Causes in Alphabetical Order

Support Resource

Intervention

See also

References

  • Katharine K. O’Dell & Sarah McGee. "Acupuncture for Urinary Urgency In Women Over 50: What Is the Evidence?". UROLOGIC NURSING - February 2006 - Volume 26 Number 1.

Template:Skin and subcutaneous tissue symptoms and signs Template:Nervous and musculoskeletal system symptoms and signs Template:Urinary system symptoms and signs Template:Cognition, perception, emotional state and behaviour symptoms and signs Template:Speech and voice symptoms and signs Template:General symptoms and signs



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