Feeling the need to urinate several times a day. It can be a tell-tale event of a problem. But which one? is the average frequency that we can consider normal? “Let’s start from the fact that most people urinate 4-6 times a day, especially during the day, producing from 700 ml to 3 liters of urine per day. If this quantity increases, we have the polyuriawhile the highest frequency is called pollakiuria and both conditions can occur at the same time. A frequent urgent need to urinate is called urinary urgency,” replies the Professor Giovanni Battista Muraro, urologist.
Is drinking less water in the evening a valid solution?
“The reason that drives us to wake up in the night to pee is to drink too much in the hours close to rest. However, our body produces a greater volume of urine during sleep, so if we generally drink little, the body becomes dehydrated and requires water during the night, resulting in the urge to urinate.
What other factors to consider?
We can list the main ones:
– the alcohol it is an enemy of rest because it stimulates the need to urinate and night thirst;
– eat spicy, salty or sweet foods close to rest it can lead to a call for water during the night and waking up to go to the bathroom;
– if you train in the evening without accompanying physical exercise with adequate hydrationthere is a high probability of waking up during the night feeling thirsty and peeing;
– constipation and obesityby weakening the muscles responsible for urinary continence, they can accentuate the frequency of going to the bathroom”.
Does the outside temperature affect the frequency of urinating?
“Yes, for example, in the summer the body temperature is regulated through sweating which reduces the frequency of urination. If the external temperature tends to drop instead, the kidneys filter the excess water in the blood. Our body, to defend the internal organs from the lowering of the temperature, reacts by increasing the frequency of urinating”.
Can some drugs also come into play?
“Administration of antihypertensives, for example, requires careful assessment of the clinical benefits and potential risks. Diuretics increase the production and expulsion of urine and therefore, in the presence of incontinence, other types of drugs must be used. Substances of abuse (amphetamines, cocaine, heroin), uncontrolled fluid intake, ADH secretion deficit in diabetes insipidus are causes of urinary incontinence. In the presence of polyuria, the doctor must therefore evaluate the presence of diabetes and, in diabetes insipidus, replace the lack of ADH production with similar drugs”.
What is meant by “overactive bladder”
“It is a widespread pathology characterized by bladder contractions that cause frequency and urgency with or without urge incontinence. There is the case of ‘wet’ overactive bladder, an incontinence with involuntary emission of urine; and ‘dry’ overactive bladder if continence is maintained. The main symptoms are nocturia, i.e need to urinate frequently during the night and polyuria”.
Then there is the problem of urinary incontinence which generally increases with old age. But what causes it and what can we do to prevent it, first of all, with a lifestyle?
“It seems that around 2.5 million people in Italy suffer from urinary incontinence and at least 50% of the elderly population. It affects women more. We are facing a problem that has a significant impact on the quality of life, especially from a socio-emotional point of view, because it leads to isolation, limiting social relationships for fear of smelling urine, eschew sexual intercourse and the discomfort of having to wear diapers: all this can become a cause of depression. The lifestyle factors that can facilitate the onset of incontinence are obesity, excessive alcohol and caffeine intake, lack of physical activity, constipation and smoking”.
When is it a symptom of a more serious health problem?
“Urinary incontinence can be a sign of serious neurological pathologies, bladder and prostate cancer; in particular, in men, it can be a consequence of prostate enlargement or its surgical removal; in women, it may occur postpartum, in menopause, or after pelvic surgery and/or genitourinary prolapse. Incontinence is also a symptom of urinary tract infections, the presence of stones and constipation. Finally, even problems related to pathologies of the spine can lead to episodes of incontinence”.