“Feeling like you have to pee right after you pee” is also called frequent urination or pollakiuria. A frequent patient complaint regarding this topic is: “is it normal to pee every 2 hours?”. The average bladder usually fills up until 300-400 ml before feeling the urge to visit the bathroom. While it is normal to urinate up to 6 times a day (every 2 hours), it is not normal “urinating 20 times a day”, as I heard from some of my patients. The more you drink, the faster your bladder fills up, giving you the urge to go to the restroom. Therefore, water intake is one frequent cause of frequent urination.
However, someone might feel like urinating even though his water intake is not that much. The urge to pass urine may come even after drinking one glass of water. Then, the desire comes not so long after having already voided. In these cases, the bladder capacity is lower than expected, or the bladder does not empty. These are the mechanism of frequent urination.
Mechanism of frequent urination
- Increased urine output: the bladder is intact, but the kidneys overproduce urine. Other than primary excessive water intake (polydipsic syndrome), this may occur because of kidney disease (Chronic Kidney Disease caused by urinary dispersing syndrome) or diseases making the urine output high, like diabetes mellitus and insipidus (polydipsia/polyuria syndrome). Diuretic medications also generate increased urine output.
- Reduced bladder capacity: the bladder is a muscle that, when it contracts, causes pressure on the urine contained, causing it to empty. There are conditions where this muscle is thicker than usual (hypertrophic), reducing the bladder capacity. Lower bladder capacity occurs even when this muscle is not entirely relaxed (hypertonic). Reduced bladder capacity is typical in bladder-neck obstruction, prostate enlargement and urethral strictures, which cause bladder obstruction and its adaptation (muscle hypertrophy, hypertonic and hypercontractivity). Patients with low bladder capacity usually complain about “I feel urge to pee but little comes out” or “why do I pee so much even when I don’t drink anything?”.
- Not complete bladder voiding: it occurs when the bladder muscle is weak, and its contraction is not enough to void the bladder completely. This is the case of long-lasting bladder obstruction (bladder-neck obstruction, prostate enlargement and urethral stricture for years), where the muscle loses strength because of prolonged stress.
- Hypercontractile bladder: the nerve supply of the bladder is damaged, and the nerve impulse to void occurs when the bladder is not full. Some neurological diseases are the leading cause of this. Urinary tract infections (UTI) activate the bladder contraction through sudden nerve impulses through an irritative mechanism. In these cases, the typical patient complaint is, “why am I peeing so much all of a sudden?”.
Causes of frequent urination
- Anterior vaginal prolapse (cystocele)
- Anxiety disorders
- Benign prostatic hyperplasia (BPH)
- Bladder stones
- Change in kidney function
- Diabetes insipidus
- Diuretics (water retention relievers)
- Excess consumption of total fluids, alcohol or caffeine
- Interstitial cystitis (also called painful bladder syndrome)
- Kidney infection (pyelonephritis)
- Overactive bladder
- Prostatitis (infection or inflammation of the prostate)
- Radiation treatment affecting the pelvis or lower abdomen
- Type 1 diabetes
- Type 2 diabetes
- Urethral stricture (narrowing of the urethra)
- Urinary incontinence
- Urinary tract infection (UTI)
Possible concomitant symptoms of frequent urination
Quite often, the “feeling like you have to pee right after you pee” is a bothering but just an isolated symptom. It usually happens when you drink too much water, coffee, tea and other caffeinated drinks. However, other symptoms may accompany the frequent urination:
- Pain or discomfort during urination: Cystitis acute and chronic, acute and chronic prostatitis;
- A strong urge to urinate: bladder obstruction (prostate enlargement, bladder-neck obstructions, urethral strictures), overactive bladder, infections and inflammations (Cystitis acute and chronic, acute and chronic prostatitis);
- Difficulty urinating: bladder obstruction (prostate enlargement, bladder-neck obstructions, urethral strictures), overactive bladder, infections and inflammations (Cystitis acute and chronic, acute and chronic prostatitis);
- Loss of bladder control: Neurologic diseases (neuro-bladder).
Ask a doctor for advice.
Sometimes frequent urination may affect your daily activities (like pulling over while driving) and impact your working performance (to interrupting business meetings). The water restriction you may do to compensate for your frequent urination may expose you to the risk of kidney stones. Ask a doctor for advice when urination is so frequent as to impact your quality of life. However, you must see a doctor urgently when you have a fever, blood in the urine and malaise.
“How to get rid of feeling like I need to pee”
This is a typical patient query after describing how bothering is this symptom. We need to start a diagnostic workup to investigate and discover the underlying disease to treat frequent urination. The treatment may include lifestyle changes, food supplements, medications or surgery according to the cause of this urinary symptom.