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Urology/Frequent need to urinate and urge to urinate

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QUESTION: I am 21 years old man.Last 5 month I have a symptoms to urinate frequently but not need to urinate in night time and day time while sleeping.I went to doctor and  give me bactrim ds.from my urine culture no any bacteria  found and from urine test no any infection.done RFT,cystoscopy,VDRl no any bad.Doctor gave me flomax and urispas but didnt work.But i have still the symptoms to urine frequent.when i travels i have a big  pressure in bladder to urinate.No any stone in bladder,ureter and kidney.What the problem is ??????

ANSWER: Pradip:

Without knowing the exact results of the tests it's difficult to come up a problem, especially if the results are reported as all normal.

You need a dietary history to assess for caffeine which can cause bladder overactivity.  You need a 24 hour voiding diary where you record for 1 day the time and amount of urine.  You may need a flow test and a CMG or bladder pressure test to identify bladder overactivity.  So far, you have only been on one bladder relaxing agent, urispas, which is generally considered relatively weak compared to the more modern therapies.

If your urinary volumes are normal, treatment with a better OAB drug might be helpful.  I doubt you needed at 21 years all the tests you've already had.  Consider getting a second opinion if your current physician is not able to help.

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QUESTION: Dear sir if i have a OAB,why i dont have to urinate in slepping period.Is this psychological??

ANSWER: Pradip:

Normally, there is reduced urine production overnite.  Also, the weight of the urine in the bladder is now on the posterior wall which is relatively stable rather than the sensitive bladder neck area which is what happens during standing and sitting.  This may account for the relatively quiet overnite voiding.

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QUESTION: From cmg test founded overactive bladder now i am using oxybutynin.In how many days it will effective for OAB?

Answer
Pradip:

Depending on the exact formulation and dosage, oxybutynin usually works relatively quickly; typically in a few days although it may take as long as a month.  If it isn't working, a change in dosage or a different medication might be needed.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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