How many times is too many?

11th, Mar 2022

There are several factors that can influence how often someone needs to pass urine. As such, there is no definitive number which is considered ‘normal’ for everybody. However, feeling concerned about the number of trips you are taking to the toilet is very normal if you have noticed a change. We spoke to Mr Ian Walsh, Consultant Urologist who helps break it down for us, tells us when to seek a professional opinion and offers his advice on good ‘urinary health’.

What would be the general consensus when we speak about how many visits to the toilet is ‘normal’?

I would advise that, rather than focusing on absolute numbers, that the most important consideration is how much “bother” any given number of visits is causing.

Also consider questions such as:  

• Is there a change in the number of trips to the bathroom?
• Is there any change to the degree of urgency to pass urine?
• Is there pain or discomfort passing urine?
• How much are lower urinary tract symptoms impacting on quality of life?
• Are there other symptoms, such as a delay in the onset of urine flow, difficulty starting or finishing, feelings of incomplete emptying?
• Is urinary incontinence becoming an issue?

If we do notice that we are running to the toilet more, are there things to consider first before becoming too concerned?

Things to consider are:

Is the increase in urinary frequency aligned with fluid intake (especially caffeinated drinks, alcohol) or dietary factors? (bladder “irritants” include spicy foods, chocolate, sugar)

Is there any associated change in urgency to get to the bathroom? Is there any loss of urine? - these symptoms will require further investigation.

Is there pain passing water? Is there blood in the urine? - the latter are worrisome symptoms and require further opinion and investigation.

What can someone do to maintain good ‘urinary health’?

Attention to both General and Pelvic Health is key in managing bladder difficulties. Improving pelvic blood flow is key to maintaining pelvic and bladder health. Exercise, healthy diet and avoidance of toxins are central to this approach. Pelvic blood flow can be improved further via specific physiotherapeutic and pharmacological means, as well as by several non-invasive approaches.

How much water should we be drinking a day?

This varies from person to person, varies with age and sex and varies with other coincident medication and health conditions. In general, clear, minimally-coloured urine is an indicator of appropriate fluid intake.

Remember that some fluids may actually act as diuretics and reduce an individual’s hydration status!

Is it true that we should be adding things like salt and lemon juice or pepper to our water to maintain fluid and electrolyte balance?

Again, this varies for each individual. Known dietary adjustments may be helpful (e.g. half a freshly-squeezed lemon each morning) are known to be conducive to urinary tract health and may be effective against urinary stone formation. In some cases, alteration of urinary pH with medication may be helpful.

What are the common issues that contribute to an increased urge to go to the toilet?

Increased urinary urgency, usually accompanied by increased frequency and sometimes associated with urgency incontinence can be aligned with a variety of issues and conditions. The troublesome symptom complex (referred to as “storage lower urinary tract symptoms (LUTS)” can be caused by bladder overactivity (hypersensitivity or instability), infection, inflammation, urinary stones or bladder outlet obstruction. Storage LUTS usually indicate the need for further investigation and therapeutic  intervention.

When should someone seek a professional opinion?

A sensible rule of thumb is to seek healthcare advice when symptoms become severe enough to cause bother. Storage LUTS are notorious for significantly interfering with quality of life and can negatively impact in activities of daily living. Absolute indications for specialist Urological opinion include infection, bleeding (visible or non-visible [“microscopic”]), incontinence, progressive/worsening symptoms, or if LUTS are aligned with other illness (e.g. neurological disease).

If you have a concern and would like to book an appointment to see one of our Urology Specialists, please email sligoadmin@kingsbridgeprivatehospital.com 

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