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Urinary Urgency and Frequency: What Should a Clinician Do?

Brubaker, Linda MD

doi: 10.1097/01.AOG.0000157029.34600.fa
Clinical Expert Series

Obstetrician–gynecologists often care for women with urinary symptoms of urgency and frequency. These symptoms are bothersome and treatable. Although it is rare that serious disease is causative, the clinician must be alert to ominous signs and physical findings. Most patients experience relief of their symptoms after a simple initial evaluation with appropriately directed treatment. A step-wise evaluation includes the directed history and physical, assessment of urinary habits, typically with a urinary diary, and occasionally an assessment of voiding efficiency, typically with a postvoid residual. Treatments may include myofascial therapy when trigger points are present on physical examination. Behavioral therapy and pharmaceuticals also play an important role. Persistent symptoms, hematuria, severe de novo postoperative symptoms, and ominous physical findings may warrant specialty consultation.

Urgency and frequency can be empirically treated when sinister symptoms, such as urinary retention, gross hematuria, or coexisting pelvic pathology, are not present.

From the Department of Obstetrics and Gynecology, Loyola University Medical Center, Maywood, Illinois.

Reprints not available. Address correspondence to: Linda Brubaker, Department of Obstetrics and Gynecology, Loyola University Medical Center, 2160 South First Avenue, Building 103, Room 104D, Maywood, IL 60153; e-mail: lbrubaker@lumc.edu.

Received May 14, 2004. Received in revised form November 8, 2004. Accepted November 9, 2004.

© 2005 The American College of Obstetricians and Gynecologists