There are several conditions that can cause frequent urination and discomfort. Any disorder that irritates the bladder, such as infection or cancer, will cause these symptoms, as will any disease that obstructs the flow of urine. In addition, interstitial cystitis is a syndrome that is used to classify chronic cases of bladder irritation that have no apparent cause.
Infections
An infected bladder, which is called cystitis, is one of the most common causes of frequent urination with discomfort. In addition, the tube that carries urine out of the bladder, the urethra, can become infected and lead to similar symptoms. Cystitis often causes pain in the middle of the pubic region, and the urine is frequently cloudy or malodorous. The urine is bloody about 30 percent of the time. While fever, chills, nausea and vomiting can result from cystitis alone, they more likely indicate that the kidneys have become infected as well. Cystitis is much more common in women then in men, due to anatomical differences in the urethra. Most cystitis is caused by bacteria that are ubiquitous on the skin, but some sexually transmitted diseases can infect the bladder and, in particular, the urethra.
Bladder Cancer
Cancer is another cause of bladder irritation that can lead to urinary frequency and discomfort. Bloody urine is common in cases of bladder cancer and often precedes irritative symptoms. Pubic pain is less common and often does not occur till the later stages of the disease. Smoking is the major risk factor for bladder cancer, along with exposure to radiation, certain dyes and other chemicals.
Urinary Obstructions
Anything that obstructs the flow of urine through the urethra can cause frequent urination and discomfort. Some children are born with strictures in the urethra that impede flow, and strictures can also develop later in life due to scar tissue. An extremely common cause of urinary obstruction in older men is an enlarged prostate gland. The prostate can become enlarged from infection, cancer or benign prostate hypertrophy. In addition, pelvic masses from a number of cancers, such as the cervical, uterine, colon and rectal, can become large enough to obstruct the urethra. Also, kidney stones can pass into the bladder and obstruct the flow of urine, although there will almost always be severe symptoms from the passage of the stone before this occurs.
Interstitial Cystitis
Interstitial cystitis is a loosely defined syndrome that includes pain and urinary frequency. Pubic pain independent of urination is most typical of interstitial cystitis, but discomfort when urinating can occur as well. The essence of the syndrome is chronic irritation of the bladder without clear cause, such as infection or tumor. There may be a characteristic type of ulceration on the inner surface of the bladder, but this finding is not necessary for all definitions of the syndrome. About 90 percent of interstitial cystitis patients are women, with an average age of around 40. Several possible causes of interstitial cystitis have been proposed, but the supporting evidence for all of them remains inconclusive.
References
- "Harrison's Principles of Internal Medicine"; Dennis L. Kasper; 2005
- Mayo Clinic: Urinary Tract Infections
- Mayo Clinic: Bladder Cancer
- Mayo Clinic: Interstitial Cystitis
