Urinary urgency

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Urgency of urination
ICD-9	788.63

Template:Search infobox Steven C. Campbell, M.D., Ph.D.

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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.

Differential diagnosis of causes of urgency

Polyuria

• Acromegaly
• Addison's disease
• behavioral or psychogenic water drinking
• Congestive heart failure
• Cushing's syndrome
• Diabetes insipidus
• Diabetes mellitus
• 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 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

Urinary tract obstruction

• Bladder neck obstruction
• Prostatic hypertrophy
• Prostatitis
• Median bar hypertrophy
• Urethral stricture
• Bladder calculi

Neurogenic bladder

• Poliomyelitis
• Parasympatholytic drugs
• Tabes dorsalis
• Multiple sclerosis
• Spinal cord lesions
• Diabetic neuropathy

Irritative lesions of the urinary tract

• Urinary tract infection
• Prostatitis
• Renal calculus
• Bladder cancer
• Kidney cancer
• Ureter cancer
• Urethral cancer

Pelvic inflammation

• Vaginitis
• Hemorrhoids
• Diverticulitis
• Appendicitis
• Salpingitis

Support Resource

• Interstitial Cystitis Network (ICN)

Intervention

• Bladder Friendly Diet (aka IC Diet)
• Behavioural Techniques
• Anti-Cholinergic

See also

• Urination
• Polyuria
• Urinary incontinence#Urge incontinence
• http://www.nlm.nih.gov/medlineplus/ency/article/003140.htm

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.