By Eric Kline, M.D., urology
Q: How many times a day should most people urinate, and what factors can change that number?
Most people urinate about 6 to 8 times a day, or roughly every 3 to 4 hours. Several factors can increase that frequency:
- Medications: Diuretics, in particular, increase urine production.
- Beverages: Caffeine and alcohol both act as bladder stimulants and diuretics, and acidic drinks (such as citrus juice or soda) can irritate the bladder.
- Foods: Spicy foods, chocolate and acidic foods can also irritate the bladder.
- Lifestyle: Tobacco use and the total amount of fluid you drink can raise frequency as well.
If you experience a sudden change in frequency, or frequency with pain, blood or excessive thirst, talk to your primary care provider.
Q: How many times a night is normal to wake up to urinate, and when does more frequent urination suggest an overactive bladder or something else?
Getting up 0 to 2 times a night to urinate is considered normal. Waking more often than that or urinating more frequently during the day than is typical for you can point to overactive bladder, incomplete bladder emptying or other conditions.
Q: With aging, at what point do bladder changes stop being “normal aging” and become something that needs treatment?
Some bladder changes are expected with age, but certain symptoms should prompt evaluation right away, such as an inability to urinate or pain with urination. Beyond those red flags, the real threshold is how much the symptoms bother you. If conservative measures, like cutting out bladder irritants (e.g., coffee and alcohol) and scheduled time to go to the bathroom (timed voiding) haven’t helped, it’s time for a formal evaluation by a professional.
That evaluation can open the door to other options, including:
- Physical therapy (exercises to strengthen the muscles of the pelvic floor)
- Medications
- Surgical intervention
Q: How do I distinguish between a UTI, overactive bladder or a pelvic floor issue?
These conditions share several symptoms, so the pattern and signs matter.
- UTI (urinary tract infection): Burning with urination, along with an increase in urgency and frequency. Other signs include pelvic pain and urine that looks red, bright pink or the color of cola.
- Overactive bladder: Typically causes urgency and frequency or both, with or without leakage.
- Pelvic floor dysfunction: Can cause the urgency and frequency seen in the conditions above. It can also cause incontinence and pelvic pain that isn’t coming from the bladder.
Q: What color should urine be?
Normal urine is clear to very light yellow. Darker yellow or amber urine usually means you’re not drinking enough fluid. Red, brown or cloudy urine may point to a cause that should be checked by your primary care provider.
Q: Should I be concerned about blood in my urine, even if it happened only once?
Yes. Blood in the urine should be evaluated even if it happens only once, because it can have many causes, ranging from infection and kidney or bladder stones to cancer. The amount of blood doesn’t reliably show how serious the cause, and the bleeding may stop on its own before the underlying problem does, so a single episode is still worth checking.
Q: Does clothing make a difference in maintaining a healthy bladder and urinary tract?
Yes. What you wear can affect bladder and urinary tract health. Here are some suggestions:
- Choose comfortable, nonrestrictive clothing.
- Wear breathable fabrics, such as cotton and other moisture-wicking materials.
- Keep the area dry and free of irritation.
Q: What are some tips you offer your patients for maintaining a healthy bladder?
Here are the habits I emphasize most:
- Drink 8 to 12, 8-ounce cups of water a day.
- Limit bladder irritants such as caffeine, alcohol, carbonated drinks, artificial sweeteners and spicy or acidic foods
- Don’t use tobacco. Smoking is a major risk for bladder cancer and can irritate the bladder lining.
- Don’t hold urine for prolonged periods of time. Go when you have the urge.
Dr. Kline practices at the Northeast and Tigard clinics, and the Alberty Surgical Center. His focus is kidney stones, benign prostatic disease, urologic cancers and no-scalpel vasectomies. His expertise is in minimally invasive robotic surgical techniques.
