What’s Normal and What’s Not: Understanding Urological Symptoms

If you’ve ever found yourself wondering, “Is this normal?” when it comes to urination, pelvic pain or other urinary tract issues, you’re not alone. Talking about bladder control, urine changes or prostate issues isn’t always easy, but ignoring these symptoms don’t make them go away. In fact, early evaluation can often lead to simpler treatment and better outcomes.

As an Advanced Practice Registered Nurse, I often meet patients who wait too long before coming in to discuss symptoms that are not only disruptive but also signs of something more serious.

In this blog, I’ll break down what’s normal, what’s not and when you should consider making an appointment with a urologist.

Frequent and Urgent Urination: Normal or Concerning?

Everyone’s bladder habits are different. On average, most people urinate six to eight times a day. More frequent urination, especially if it’s interfering with daily life or sleep, may be a sign of:

• Overactive bladder
• Urinary tract infection
• Diabetes
• Bladder stones or inflammation
• Enlarged prostate in men

The sudden, intense need to urinate, known as “urgency,” can point to an overactive bladder or other underlying conditions. With the help of lifestyle changes, medication or minimally invasive procedures, these symptoms can be managed. 

Getting Up at Night: Should You Worry?

Waking up once a night to urinate is common, especially as we get older, but if it reaches two or more times every night, that’s something to pay attention to. Frequent nighttime urination is known as nocturia and can disrupt your sleep, indicating:

• Prostate enlargement
• Diabetes
• Sleep apnea
• Poor bladder storage

Hydration habits and medications may also play a role, but persistent nighttime urination is worth a discussion with your doctor or urologist.

Blood in the Urine: Always a Red Flag?

Blood in the urine, called Hematuria, is never considered normal and should always be shared with your healthcare provider. Red, pink or tea-colored – or if a urine test that shows blood without visible signs – may signal a problem caused by: 

• Urinary tract infection
• Kidney or bladder stones
• Bladder or kidney cancer
• Prostate conditions

It might be nothing serious, but it also might be your body’s way of signaling a more dangerous condition. Early detection is key, especially in cases of bladder cancer, where symptoms can be subtle at first.

Weak Stream or Hesitation: What’s the Cause?

For men, a slow or interrupted stream is often linked to benign prostatic hyperplasia (BPH), or an enlarged prostate. This condition is very common – more than half of men over 50 experience it – and while it’s not cancer, it can seriously affect your quality of life.

Symptoms include:

• Straining to urinate
• Dribbling after urination
• Feeling like your bladder doesn’t fully empty
• Hesitation when starting to urinate

There are a range of treatments available, from medications to outpatient procedures that can relieve symptoms without major surgery.

Pelvic Pain or Pressure: What Could it Mean?

Persistent discomfort in the pelvic region – including the lower abdomen, genitals or lower back – can have many causes. It may be a sign of:

• Chronic prostatitis or pelvic pain syndrome
• Bladder inflammation
• Interstitial cystitis
• Infections
• Kidney stones

If you’re experiencing ongoing pain or pressure that doesn’t go away with over-the-counter remedies, we can help you find the root cause and create a personalized treatment plan that works.

Urinary Incontinence: How Common Is It?

Urinary incontinence – the unintentional leakage of urine – affects both men and women and is more common than people realize. Causes range from childbirth and aging to prostate surgery or nerve-related conditions.

There are different types of incontinence:

• Stress incontinence — leaking when coughing, sneezing or lifting
• Urge incontinence — a sudden, strong need to urinate followed by leakage
• Overflow incontinence — incomplete emptying of the bladder
• Functional incontinence — inability to reach the toilet in time due to physical or cognitive limitations 

Treatment options include pelvic floor therapy, medication, devices and even outpatient surgical solutions so you don’t have to live with discomfort.

When to See a Urologist

Seeing a urologist before symptoms become severe can lead to more effective, less invasive treatments and can often prevent complications down the road.

Consider making an appointment if you’re experiencing:

• Frequent urination or urgency
• Getting up more than once per night to urinate
• Pain or burning during urination
• Blood in the urine
• Weak stream or difficulty starting to urinate
• Ongoing pelvic or bladder pain
• Any kind of incontinence
• Concerns about prostate health

At TMH Physician Partners – Urology, we specialize in diagnosing and treating a full range of urologic conditions. Whether it’s time for a prostate screening or you’re just tired of waking up five times a night, we’re here to help you feel better and regain control.

If you’re experiencing urological symptoms or want to explore how our urology services can support your health, talk with your primary care provider for a referral — or in some cases, you may be able to self-refer. Visit TMH Physician Partners - Urology for more information.

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Timothy Hann, APRN