Is It Normal to Pee 20 Times a Day?

Urinary frequency is characterized by a need to urinate more than seven times per day when drinking about 2 liters of fluid. 

Depending on the cause, urinary frequency may be accompanied by symptoms such as: 

• Urinary urgency
• Incontinence
  • Unintentional passage of urine, frequently when bending, coughing, or sneezing
• Urinary hesitancy/retention
• Poor urine stream
• A sensation of incomplete voiding
• Pain or urinary leakage during sexual intercourse
• Pain during urination
• Nighttime urination
• Sensation of vaginal fullness
• Urethral discharge with fever, chills, low back pain, muscle and joint pain, and perineal fullness
• Prostate tenderness
• Foul-smelling urine
• Flank pain

Medical conditions that can cause urinary frequency include: 

• Urinary tract infections (UTIs)
  • The most common cause in women and children
• Urinary incontinence
• Urinary tract calculi
• Urethral stricture
• Bladder detrusor overactivity
• Prostate problems
  • Benign prostatic hyperplasia (BPH)
    • A common cause in men over 50 years of age
  • Prostatitis
  • Prostate cancer
• History of radiation therapy of the lower abdomen, prostate, or perineum for treatment of cancer
• Cystocele
• Reactive arthritis
• Spinal cord injury or lesion
• Sexually transmitted infection (STI)
  • Chlamydia
  • Gonorrhea
  • Herpes
  • Trichomoniasis

Causes of urinary frequency in people who do not have underlying medical conditions may include: 

• Use of diuretics
• Excessive intake of caffeine 
• Alcohol intake
• Pregnancy

Urinary frequency is diagnosed with a patient history and physical examination, which may include a rectal exam and/or a pelvic exam.

Tests used to diagnose the cause of urinary frequency may include: 

• Urinalysis 
• Urine culture
• Cytoscopy
• Cystometry
• Urethrography 
• Ultrasonography
• Voiding cystourethrography
• Prostate-specific antigen (PSA) level 
• Prostate biopsy 
• Sexually transmitted infection (STI) testing

Treatment for urinary frequency depends on the cause. 

• Treatment for urinary frequency due to urinary tract infections (UTIs) may include:
  • Antibiotics
  • Medications to numb the bladder and urethra and reduce the burning pain of some UTIs 
  • Medications for fever and pain
  • Hospital treatment: intravenous (IV) antibiotics and fluids
• Treatment for urinary frequency due to urinary incontinence may include:
  • Lifestyle changes
    • Drinking less during the day or drink less before bedtime
      • Talk to your doctor about how much fluid you need 
    • Exercise regularly
    • Maintain a healthy weight
    • Avoid constipation
    • Don’t smoke
  • Bladder training
    • Pelvic floor exercises
    • Urgency suppression
  • Medications
  • Catheter
  • Pessary
  • Bulking agents
  • Electrical nerve stimulation
  • Surgery
• Treatment for urinary frequency due to bladder detrusor overactivity may include:
  • Behavioral therapies and education
  • Medications
  • Intradetrusor injection of onabotulinumtoxinA 
  • In rare and severe cases, augmentation cystoplasty or urinary diversion
     
• Treatment for urinary frequency due to urinary tract calculi may include:
  • Drinking plenty of water
  • Pain relievers 
  • Other medical therapies
  • Extracorporeal shock wave lithotripsy 
  • Reteroscopic stone fragmentation and removal (URS) 
  • Surgery
• Treatment for urinary frequency due to urethral stricture may include: 
  • There are no available drugs to help treat strictures
  • Dilation 
  • Urethrotomy 
  • Surgical removal of the stricture 
• Treatment for urinary frequency due to prostate problems depends on the problem and may include:
  • Benign prostatic hyperplasia (BPH)
    • Watchful waiting (active surveillance)
    • Lifestyle changes 
    • Medications to help stop prostate growth or shrink the prostate 
    • Alpha-blocker medications to relax prostate and bladder muscles to ease symptoms
    • Radio waves, microwaves, or lasers which use different kinds of heat to reduce extra prostate tissue to treat urinary problems caused by BPH
    • Surgery 
  • Prostatitis
    • Drink plenty of fluids
    • Antibiotics 
    • Pain medications 
    • Lifestyle changes
    • Surgery in some chronic cases
  • Prostate cancer
    • Watchful waiting (active surveillance)
    • Surgery
    • Radiation therapy
    • Hormone therapy
• Treatment for urinary frequency due to cystocele may include:
  • Activity changes
  • Kegel exercises
  • Hormone replacement therapy
  • Pessary
  • Surgery
• Treatment for urinary frequency due to spinal cord injury or lesion may include:
  • Bladder management
  • Catheterization
• Treatment for urinary frequency due to sexually transmitted infection (STI) can vary depending on the infection and may include:
  • Antibiotics 
  • Antiviral medicines 
  • Antibiotic/antiprotozoal medications
  • Keeping the genital area clean and dry
  • Avoiding tight clothing
  • Sitz bath
  • Over-the-counter (OTC) pain medicines 
  • Treating sexual partners