Frequent urination, the need to urinate many times during the day and at night (nocturia), or both, but normal or less than normal amounts. The frequency may be accompanied by a feeling of emptying an urgent need (urinary urgency). Frequent urination is distinguished from a polyuria, in which a urinary excretion of> 3 l / day occurs. Pathophysiology Urinary frequency arises usually from diseases of the lower urogenital tract. An inflammation of the bladder, urethra or both, causing a feeling the need to urinate. However, this feeling is not relieved by emptying the bladder, so that the patient when the bladder was emptied, try again to urinate, but can withdraw only small amounts of urine. Etiology There are many causes of frequent urination (see table: causes of urinary urgency), but the most common include UTI urinary incontinence Benign prostatic hyperplasia (BPH) urinary tract stones cause of urinary urgency cause suspicious findings diagnostic approach Benign prostatic hyperplasia or prostate cancer Progressive start of urinary retention, incontinence, poor urine, a feeling of incomplete evacuation Rectal examination sonography Cystometry Zystocele urinary incontinence bloating vaginal pain or urinary leakage during intercourse Gynecological examination voiding cystourethrography drugs and substances caffeine alcohol diuretics Urinary frequency in an otherwise healthy patient Empirical elimination of the triggering substance (to confirm that the frequency decreases) Pregnancy third trimester of pregnancy Clinical B aluation prostatitis urgency, dysuria, nocturia, purulent discharge from the urethra with fever, chills, low back pain, muscle pain, joint pain and fullness in the perineal region Prostate tender palpation Rectal examination culture of secretions after prostatic massage Radiation-induced cystitis Preceding radiotherapy of the abdomen, prostate or the dam for the treatment of cancer Clinical evaluation cystoscopy and biopsy reactive arthritis Asymmetric arthritis of the knees K Nöchel and metatarsophalangeal joints Unilateral or bilateral conjunctivitis Small, painless sores on the mouth, tongue, glans penis, glans, palms and soles 1-2 weeks after sexual contact tests for sexually transmitted diseases injury or lesion of the spinal cord lower limb weakness, decreased anal Sphinkertonus, lack of anal reflex loss of sensation in a segment level of injury is usually clinically obvious MRI of the spine urethral stricture, urinary retention and tenesmus, weakening of the urinary stream urethrography Urinary incontinence Unintentional departure of urine, especially when bending over, coughing or sneezing cystometry urinary tract stones Colicky pain the flank or in the groin urinalysis on hematuria sonography or CT of the kidneys, ureters and bladder UTI dysuria and foul-smelling urine, sometimes fever, confusion, flank pain, especially in women and girls dysuria and urinary frequency in young, sexually active men (pointing to an STD back) urinalysis and urine culture tests for sexually übert ragbare diseases Blasendetrusorhyperaktivität nocturia, urge incontinence, weak urinary stream and sometimes urinary retention cystometry STD = sexually transmitted disease. Assessment history In the history of the present illness should be asked first for the amounts of consumed and excreted liquid to distinguish between urgency and polyuria. If a frequent urge to urinate is that patients on the speed of onset, presence or absence of irritative symptoms (such. As irritation, urgency, dysuria), (obstructive symptoms such. As urinary retention, low flow, sensation of incomplete bladder emptying , nocturia) and on recent sexual contacts interviewed. In reviewing the organ systems should be sought for possible causal symptoms, including fever, pain in the flanks or in the groin, hematuria (infection); lack of menstruation, breast swelling and morning sickness (pregnancy), as well as arthritis and conjunctivitis (reactive arthritis). The medical history should be asked, including prostate disease and past radiation therapy or surgery of the pelvis known causes. Medications and diet are checked for the use of substances towards that lead to increased urine output (z. B. diuretics, alcohol, caffeinated beverages) .Körperliche examination The physical examination focuses on the urogenital system. Any type of urethral discharge or lesions that are associated with sexually transmitted diseases are noted. Rectal exam of men the size and consistency of the prostate and Rektaltonus should be noted; at the gynecological examination of women’s presence should be taken of cystocele. Patients should be instructed to cough, while the urethra is observed for signs of urinary incontinence. The kostovertebrale angle should be scanned in sensitivity, and in the investigation of the abdomen is to be ensured masses or suprapubic sensitivity. In the neurological examination, a test should be on lower limb weakness and loss of sensation erfolgen.Warnhinweise The following findings are particularly important: lower limb weakness or signs of spinal cord damage (eg loss of sensation in a segment level, loss of anal. sphincter tone and Analreflexes) fever and back pain interpretation of the findings A dysuria due to frequent urination due to UTI or calculi. Past operations of the pelvis justify the suspicion of incontinence. Weak urinary stream, nocturia, or both have a suspect BPH. Urinary frequency in an otherwise healthy young patients may be due to excessive intake of alcohol or caffeinated beverages. Gross hematuria due to suspicion of a UTI and calculi in younger patients and cancer in elderly Patienten.Tests In all patients, a urinalysis and culture are required which are easy to perform and be recognized by the infection and hematuria. Cystoscopy, cystometry and Urethrography can be performed to diagnose bladder infection, bladder outlet obstruction and cystocele. PSA Bestimmungt, ultrasound and biopsy of the prostate may be required, especially in older men to distinguish BPH from prostate cancer. Therapy Treatment varies depending on the causes. Basics of Geriatric Urinary frequency in older men is often caused by bladder neck obstruction due to prostate enlargement or cancer. In these patients, usually the determination of residual urine is necessary. A HWI or the use of diuretics can be the cause in both sexes. Conclusion A UTI is the most common cause in children and women. Prostate disease is a common cause in men> 50 years. Excessive intake of caffeine can cause frequent urination in healthy people.