Urinary Urgency

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is urinary urgency?

Urinary urgency is the sensation that the bladder must be emptied immediately regardless of bladder volume. Urinary urgency can occasionally wake a person from sleep and is sometimes accompanied by urinary incontinence, or the loss of urine. Other symptoms that may accompany urinary urgency include bloody or pink-colored urine (hematuria); cloudy urine; difficulty urinating (dysuria); fever; foul-smelling urine; frequent urination; lower abdominal, pelvic or back pain; pain or burning with urination; and penile or vaginal discharge.

Urinary urgency can be caused by conditions affecting nearby structures, infection, inflammation, injury, irritation, kidney or bladder stones, nervous system abnormalities, and tumors. Irritation of the bladder and urethra can result from trauma or can be due to chemicals in soaps, spermicides, lubricants, bubble baths, or other substances. Inflammatory causes of urinary urgency include inflammation of the urethra (urethritis), prostate (prostatitis), or bladder (cystitis). Infections of the bladder or prostate and sexually transmitted diseases, such as gonorrhea and Chlamydia, can also cause urinary urgency.

Conditions that can obstruct urine flow, such as benign prostatic hypertrophy (BPH), kidney or bladder stones, and tumors of the bladder or urethra, can sometimes cause urinary urgency.

Overactive bladder syndrome and nervous system abnormalities, such as spinal cord injury and multiple sclerosis (disease that affects the brain and spinal cord causing weakness, coordination, balance difficulties, and other problems), can be associated with abnormal bladder contractions and urgency.

Because urinary urgency that is persistent or accompanied by other symptoms may have a treatable cause, you should seek prompt medical c are if you have urinary urgency.

Cancer, infections, and trauma can lead to life-threatening complications, including cancer spread, hemorrhage, and infections of the kidneys and bloodstream. Seek immediate medical care (call 911) for serious symptoms, such as change in level of consciousness; change in mental status; high fever (higher than 101 degrees Fahrenheit); not producing any urine; severe abdominal, pelvic or back pain; severe nausea and vomiting; or uncontrolled or heavy bleeding.

What other symptoms might occur with urinary urgency?

Urinary urgency may accompany other symptoms that vary depending on the underlying disease, disorder or condition. Symptoms that frequently affect the bladder, urethra or prostate may also involve other body systems.

Urinary tract symptoms that may occur along with urinary urgency

Urinary urgency may accompany other symptoms affecting the urinary tract including:

  • Bloody or pink-colored urine (hematuria)

  • Cloudy urine

  • Foul-smelling urine

  • Frequent urination

  • Pain or burning with urination (dysuria)

  • Urinary incontinence (inability to control urination)

Other symptoms that may occur along with urinary urgency

Urinary urgency may accompany symptoms related to other body systems including:

  • Abdominal, pelvic or back pain that can be severe

  • Blood in the semen (hematospermia)

  • Fatigue or general ill feeling

  • Fever and chills

  • Itching of the penis or groin

  • Pain during sexual intercourse or with ejaculation

  • Paralysis

  • Pins-and-needles (prickling) sensation, loss of sensation

  • Swelling, especially of the lower legs

  • Unexplained weight loss

  • Vaginal or penile discharge

  • Weakness (loss of strength)

Serious symptoms that might indicate a life-threatening condition

In some cases, urinary urgency may be a symptom of a life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

What causes urinary urgency?

Urinary urgency can be caused by conditions affecting nearby structures, infection, inflammation, injury, irritation, kidney or bladder stones, nervous system abnormalities, and tumors.

Inflammatory and irritative causes of urinary urgency

Urinary urgency may be caused by inflammatory or irritative conditions including:

  • Exposure to chemicals in soaps, spermicides, lubricants, bubble baths, or other substances

  • Interstitial cystitis (inflammation of the bladder wall unrelated to infection)

  • Prostatitis (inflammation of the prostrate)

  • Reiter’s syndrome (form of arthritis)

  • Trauma

  • Urethritis (inflammation of the urethra)

Nervous system causes of urinary urgency

Urinary urgency can also be caused by nervous system abnormalities including:

  • Brain or spinal cord injury

  • Brain or spinal cord tumors

  • Multiple sclerosis (disease that affects the brain and spinal cord causing weakness, coordination, balance difficulties, and other problems)

  • Parkinson’s disease (brain disorder that impairs movement and coordination)

  • Spina bifida (incomplete closure of the spine during development)

  • Stroke

  • Traumatic brain injury

Other causes of urinary urgency

Urinary urgency can also be caused by other diseases, disorders or conditions including:

  • Benign prostatic hypertrophy (BPH; enlargement of the prostate that occurs with age)

  • Kidney or bladder stones

  • Overactive bladder syndrome

  • Pelvic organ prolapse

  • Sexually transmitted diseases, such as gonorrhea and Chlamydia

  • Tumors of the bladder or urethra

  • Urinary tract or prostate infections

Serious or life-threatening cause of urinary urgency

In the case of severe trauma, urinary urgency may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting.

Questions for diagnosing the cause of urinary urgency

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your urinary urgency including:

  • When did you first notice your urinary urgency?

  • Do you have any other symptoms?

  • Is there anything that increases or lessens your urinary urgency?

  • Do you have any other medical conditions?

  • Have you experienced any trauma?

  • Have you made any changes to your diet?

  • What medications are you taking?

What are the potential complications of urinary urgency?

Because urinary urgency can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

  • Adverse effects of treatment

  • Avoidance of sexual activity

  • Chronic or frequent urinary tract infections

  • Decreased bladder capacity

  • Inability for self-care

  • Kidney damage or failure

  • Ongoing or worsening symptoms

  • Pelvic inflammatory disease (PID, an infection of a woman’s reproductive organs)

  • Scarring of the urinary tract

  • Sepsis (life-threatening bacterial blood infection)

  • Social isolation

  • Spread of a sexually transmitted disease to a partner

  • Spread of cancer

  • Spread of infection

  • Weight gain (reduced exercise from fear of leakage)

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Nov 23
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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