A compelling need to urinate (urgency), which may feel like almost constant painful straining (tenesmus), can be caused by bladder irritation. Uncontrolled loss of urine (incontinence) may occur if a person does not urinate immediately. Urgency may be caused by a bladder infection. Caffeine and alcohol use may contribute to urgency but rarely cause severe urgency by themselves. Rarely, inflammation of the bladder (interstitial cystitis) is the cause.
Doctors can usually determine the cause of urgency because of the person’s symptoms, the results of the physical examination, and urinalysis. If infection is suspected, urine culture may be needed. Sometimes, particularly if interstitial cystitis is suspected, doctors may insert a flexible viewing tube into the bladder (cystoscopy) or do a biopsy of the bladder.
Doctors treat the cause of urgency.
(See also Overview of Urinary Tract Symptoms.)