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Q. I have increased urgency to urinate. Do you think this is OAB?

Answered by
Dr. Shahil Khant
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 24, 2018

Hi doctor,

I am a 23 year old male, a third-year medical student. For the past seven days, I have had an increased urgency and frequency to urinate. I can go even more than 30 times a day - majority of these times, I feel an increased urgency. However, when I go, only a small amount or drops come out. For the past two to three days, the urgency kind of feels to be getting worse, I feel as if I will not be able to hold it. However, I am still able to as there is no leaking. There is no burning or irritation or any discharge. No recent sexual encounters and no other associated symptoms. I take Coveram 10/10 for essential hypertension and Valdoxan 25 because I also do suffer from anxiety. I have been under stress lately as I was doing my exams this past week and finished today. I have done a few tests at my family doctor: Last week I did a dipstick which was normal apart from +1 protein. Voiding bladder US was normal (450 mL pre voiding, 45 mL post voiding). An initial urine culture was normal according to my doctor. Yesterday, I performed another dipstick and urine culture. The dipstick was normal, and early urine microscopy showed 10 to 100 white cell count. We are waiting for the cultures to return. Due to the result of the white cell count, my doctor said it would be worth a try to undergo a 5-day course of antibiotics (Keflex).

Today is my third day of antibiotic treatment, symptoms are largely the same. Today, I attempted to hold my bladder. It felt fine in the morning but as the day went on, my symptoms returned and I am finding it harder to hold my bladder. Also, for the first time, I tried going for a run. The entire time I felt a heaviness in my bladder and felt a strong urge to urinate, even though I went before my run began. What do you think could be going on? My doctor believes that it is either a UTI, or most likely, a hypersensitive bladder due to exam stress. However, there have been days where I have not felt stress at all yet symptoms have continued. I am really worried as I want to go back to work in five days and I do not think I will be able to manage the way things are at the moment. My family doctor does think this will settle down now that I have finished exams. Do you think there is a chance it could? I have mentioned this query to another doctor online, and he believed it may be due to an overactive bladder. However, since I am relatively young to receive this diagnosis, I wanted a second opinion, if that is alright. Do you think this could be OAB? I am worried that it could be something serious, like multiple sclerosis. One and a half years ago, I had an episode of sudden onset numbness in one arm and fearing the same thing, I ended up having an MRI of my brain and lumbar spine which both came back negative. Do you think this could be MS?

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Hello,

Welcome to icliniq.com.

Relax and do not worry.

As per your symptoms, it looks like overactive bladder only.

Do you have any problem with the flow of urine? Or hesitation?

Anyhow, as you are taking antibiotics better finish the course.

I would like you to:

  1. Maintain a bladder diary for three days (you can search online for bladder diary).
  2. The first line of treatment for OAB starts with bladder training, behavior training with urge suppression and pelvic floor exercises.
  3. The first line medications are anticholinergics such as tablet Solifenacin 5 mg morning and night.
  4. There is no problem with ultrasound (attachment removed to protect patient identity). Pre and post voids are fine.
  5. If you want you can consult your doctor and start Solifenacin or complete bladder dairy for three days send to me and then start Solifenacin.

Here are the answer to your questions.

  1. It is overactive bladder, it is not stress related. It is treatable but you require patience.
  2. Yes, it is OAB.
  3. No, I do not think it is MS as of now. So do not worry.

It is better if you consult a urologist so that, he can explain you in detail.

Anyhow, I will be ready to help anytime.

For more information consult a urologist online --> https://icliniq.com./ask-a-doctor-online/urologist

Hello doctor,

Thank you for your quick reply. I have already begun trying to bladder train. I have been able to hold my urine for two to three hours at a time today although it has been quite difficult. Is there a chance the OAB will go away on its own? I am pretty young at 23 to have this issue. I have spoken to my mother who had the exact presentation a few months ago and she said it all settled down by itself after around two weeks.

#

Hello,

Welcome back to icliniq.com.

It can happen to anyone and is not related to age. If it is due to infection, then it should resolve as you are already taking antibiotics.

It is good that you have started bladder and behavior training.

Apart from medicines, it is your mind. A strong emphasis should be given to behavior training like urge supression.

In some people, it may get cured. For some, there is a need to control it with medicines. We cannot predict.

For more information consult a urologist online --> https://icliniq.com./ask-a-doctor-online/urologist

Hello doctor,

Thank you again for your reply. To answer your first question, yes I definitely feel as if the flow of the urine has become weaker. Is that expected with OAB? Also, how long can I expect before I can return to normal functioning? Because I would like to start work again as soon as possible.

#

Hello,

Welcome back to icliniq.com.

Yes, the flow can be low. But it also depends on the volume of urine passed. If the amount of urine passed is low, then low flow is expected.

You will get normal. Do not worry. Just continue your routine and do not think too much about this.

Start Soliten 5 mg morning and evening. Definitely, you will get relief.

For more information consult a urologist online --> https://icliniq.com./ask-a-doctor-online/urologist


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