The term frequency refers to the increase in the total number of urinations per day without increases in the amount of urine that is expelled. In fact, the most common is that the diuresis is scarce in each trip to the bathroom. It should not be confused with polyuria, which is the increase in the amount of urine passed.
The word polaquiuria has Greek roots. The initial part comes from the lexicon cockkis, which means "frequent" or "often"; Y ouron, pronounced “oura”, it is understood as relative to urine; the suffix "ia" is added to indicate quality. The official translation would be "frequent urination" or "urinate often".
There are several causes of frequency. The most numerous are closely related to the urinary system but are not exclusive to it. Some systemic diseases or distant diseases can generate this condition, and there are also phenomena related to gender and age group that explain some cases of frequency..
Treatments for frequency will depend on the etiology of the condition. As happens many times in the medical universe, there are pharmacological and surgical treatments, but a separate part must be added for behavioral and psychological therapy, which plays a fundamental role in the management of many cases of frequency..
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Although frequency has particular characteristics, it is not correct to give it its own symptoms since frequency itself is a symptom. It is part of the syndromic elements of several urinary pathologies and of many other systemic ones. Among its most important features we have the following:
Its etymology thus defines it; there is an increase in the number of urinations. Some authors consider that going to the bathroom 8 or more times a day can already be considered frequency, regardless of the total amount of diuresis that occurs in the 24 hours.
Although the number of times you go to the bathroom increases, the same does not happen with the amount of urine that is expelled; quite the opposite. The patient reports that he goes to the bathroom many times but urinates a small amount.
Another frequent complaint from patients is that the increase in the number of urinations occurs more at night. This condition is known as nocturnal frequency and is diagnostic from a diagnostic point of view..
The frequency does not usually come alone. It is accompanied by other urinary symptoms such as dysuria (painful expulsion of urine) or urgency (urgent and permanent need to urinate even when the bladder is empty). The presence of other symptoms such as blood in the urine, high fever, chills, and abdominal pain can signify infections or tumors..
There are many diseases that have frequency as a habitual or casual symptom. As already mentioned, most of these affect the genitourinary system, but not exclusively. The most frequent are mentioned below:
It is the most common cause of frequency. Any local infectious picture that alters the normal functioning of the urinary system, can cause an increase in the number of daily urinations.
Dysuria is also common in these cases. It affects more women than men and can be accompanied by high fever, chills, and abdominal or lower back pain.
In laboratory tests, elevated white blood cells and neutrophilia can be found in complete hematology and presence of bacteria, leukocytes, nitrites, and blood in urinalysis..
Inflammation of the bladder, infectious or not, is also a common cause of frequency. Inside the irritated bladder the presence of urine is not well tolerated, so the body seeks to empty it frequently. Dysuria, hematuria, and hypogastric pain are common concomitants of cystitis.
Infection, reactive inflammation, abnormal growth, and prostate cancer are causes of frequency unique to males. The proximity of the prostate gland to the urinary tract, especially its intimate relationship with the urethra, favors its alterations having an impact on voiding function.
One of the earliest signs in a diabetic patient is frequency. In fact, it is one of the first reasons for consultation why a person who is not yet known to be diabetic goes to the doctor. Initially it presents with polyuria and later becomes frequency due to the progressive deterioration of glomerular filtration..
One of the constant complaints of pregnant women is the need to go to the bathroom very often. During pregnancy, several physiological phenomena are triggered that favor the increase in renal blood flow and the constant emptying of the urinary bladder..
Physically speaking, the pressure exerted by the growing fetus on the pelvic organs prevents the bladder from filling completely and forces it to repeatedly discharge its contents. Likewise, there is an effect known as the physiological hydroureter of the pregnant woman, due to dilation of the urinary tract, increasing the frequency of voiding..
Finally, in pregnant women there is excessive release of various hormones. Some of these cause an increase of up to 50% in glomerular filtration, which immediately translates into greater urine production and, therefore, frequency.
Many are the drugs that, acting on the renal system, cause an increase in the number of urinations. The most obvious are diuretics.
These drugs universally used for the treatment of arterial hypertension, among other pathologies, produce polyuria or frequency, depending on how the patient's kidneys are..
Other medications that can cause frequency include anticonvulsants, lithium, and diphenhydramine. Some substances of mass consumption associated with increased urination are caffeine, alcohol and some infusions or teas.
Cerebrovascular, ischemic, or hemorrhagic diseases can contribute to the appearance of frequency. The mechanism through which this occurs seems to be associated with cellular damage in areas of the brain, responsible for the production and release of hormones and neurotransmitters that drive the urination process..
Certain spinal cord injuries - congenital, tumorous or traumatic - damage the nerves that control the bladder and alter their function. One of the consequences of this injury is the overactive bladder syndrome, which causes frequent and scanty urination, urinary incontinence and overactivity of the bladder detrusor muscle..
Mental illnesses, such as anxiety and depression, count among its symptoms with urinary disturbances. In fact, voiding syndrome, whose symptoms include frequency, has among its possible causes psychological or psychiatric disorders.
The presence of kidney stones, capable of obstructing the normal flow of urine, is a common cause of frequency. The same occurs with urethral stricture, since this condition does not allow normal bladder discharge, leaving the sensation of incomplete urination and forcing the patient to go to the bathroom more frequently..
As mentioned above and in previous publications, symptoms are not treated, causes are treated. This means that frequency is not handled particularly but the etiology of it. However, there are general therapeutic measures that alleviate this urinary disturbance, including the following:
Being urinary infections the main causes of frequency, it is evident that by treating these, the symptom improves. The germs involved in urinary tract infections are usually gram-negative bacteria, especially Enterobacteriaceae, which respond to therapies with macrolides, third- or fourth-generation cephalosporins, and quinolones..
In case the bacteria are multi-resistant and produce an important touch of the general state, the carbapenems are of choice. Treatment is supplemented with urinary tract antiseptics and antispasmodics, such as nitrofurantoin and flavoxate..
Glycemic control is essential in the management of diabetic patients and to avoid frequency. Hence, oral hypoglycemic agents and insulin are very useful medications to control this condition. They must be indicated by a specialist doctor after a thorough physical and laboratory examination.
Benign prostate diseases are also managed with drug therapies. Prostate growth is treated with 5-alpha-reductase inhibitors and alpha blockers, relaxing bladder smooth muscle. Prostatitis may require antibiotics, anti-inflammatories, and occasionally steroids.
Prostate cancer should be managed in conjunction with urology and oncology services. Initial treatment includes chemotherapy, radiation therapy, and hormone inhibitors, which prevent rapid tumor development and can destroy cancer cells..
It is indicated in some types of prostate cancer when the response to primary therapy is inadequate or when it is part of the oncological protocol for the disease. Other types of tumors - such as gynecological or gastrointestinal, which can indirectly affect the urinary tract - can also be corrected through surgery..
Partial prostatectomy is an option when the growth of the prostate makes urination very difficult and impairs the quality of life of the patient. It can be done abdominally or transurethrally.
Certain bladder disorders also respond well to surgery, such as interstitial cystitis. The same happens with kidney stones that cannot be expelled through the urine and get stuck in the ureters.
Overactive bladder can be managed with medications, such as tolterodine or imipramine, but bladder retraining is essential: the patient must learn to urinate again.
In these cases, psychological therapy is very valuable. Some physical therapies are also appreciated in pregnant patients with frequency..
Acupuncture has been used since ancient times for the treatment of voiding disorders. Although it is not known exactly how it works, the results are encouraging, especially in women with urinary incontinence and urgency..
Although everything explained in the previous sections may affect the child, with obvious exceptions, there is a particular clinical picture in pediatrics that presents with frequency. This condition is known as benign frequency of childhood, and despite the concern it generates in parents and doctors, it is not serious..
These patients, mainly between 4 and 8 years of age, are taken by their parents to the pediatrician due to the urgent need they have to go to the bathroom. This urination urgency occurs anywhere and at any time, affecting school performance and daily daily activities.
Although it is a ruling out diagnosis, the authors suggest a psychological etiology of the condition. It is related to the pressure exerted by the elderly to learn to go to the bathroom, which coincides with the age of onset. Therefore, the treatment is based on behavioral therapy, adequate training and an end to pressure on the child..
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