urge and frequency getting worse, whats gonna happen

Hi, I'm a 22 year old male with over active bladder that has seem to be worsening in the past few months. I was in denial about how bad it was, thinking that it was a problem with dry mouth or not being able to get a full sleep. Right now I feel an urge to urinate every 15 - 30 mins, during the day its every hour. I'm not working or in school, which made it feel like my problems weren't as bad, but I've had so many close calls either going on a long walk or driving a long distance with my friends. I have to choose between hydrating enough or potentially having an accident or the embarrasment from having to get up ever 15 mins to the bathroom.

I just want to know what I'm in for if I go to a urologist. What kind of tests do they do? I hear some involve catheters and thats one of my greatest fears so I'm not sure if I'd be able to handle it without freaking out.

I want to go 24/7 if the issue doesn't get better just cause I'm tired of having to get up so often while I'm doing things. It would raise a lot of questions at work and school I would think, I'd rather just change something every 4 or so hours then deal with that. IDK though if its an appropriate treatment for that level of urge. I've only wet my bed once but I get up 1-3 times during the night and I'm dribbling much more during the day. It seems reasonable to me to wear diapers but I feel like being abdl clouds my judgement for obvious reasons.

Of course you need to see a general practitioner first to get everything else ruled out. As for the urologist, if they don't find anything else wrong, you will surely be sent there. Medicines might work in your case, so don't sweat it for now. Also you appear to be young so here's a hint: your body plays more tricks on you the older you get and it's easier if you accept it. Dr. visits and such get more irritating over time, but that's how it goes.

I think that sometimes people get a little over active with hydration, so I have to ask: how much liquid do you drink in 24 hours?

Yes, your ABDL status could cloud your judgement a little. But hey at least you don't hate diapers, right?

I drink about 3/4's a gallon a day I think, maybe more. The thing about the medications is some of them cause dry mouth, when thats already a problem for me normally plus I'm on adderall. I don't think stopping the adderall is a good idea cause it helps so much and I'm on such a low dose anyways.

NO, you don't have to see your GP first. If you have a PPO style health plan (assuming you're US based) you can just go see a urologist. Most primary care doctors are simply going to refer you anyway so if you can often skip that step. That's how I handled my OAB/Incon. I'm not even sure if my primary care doc ever got a report or anything from the urologist as they're in different networks.

Anyway with the urologist, if you describe symptoms that sound like OAB, the doc will likely diagnose you as having it. Normally, invasive tests are not initially needed to diagnose OAB. Usually on the first visit for OAB-like complaints they'll simply take a urine sample and may do a post void ultrasound to see if you have retention issues. This is all it took for me and the doc agreed that my symptoms all pointed to OAB. I was given meds and sent on my way.

If/when the meds don't work or you don't like the side effects, they might want to confirm the OAB diagnosis with more invasive tests. This could include cystoscopy to visually inspect the bladder and rule out bladder cancer/stones/etc. They may also do urodynamic testing as well. This includes putting a couple very small catheters in you to fill your bladder with water. Pressure censors in the catheter and in your rectum measure pressure differences and can see if your bladder contracts and spasms as it should if you have OAB. The problem is, sometimes your bladder won't cooperate with the tests. I have textbook OAB but when I had my urodynamics testing done they couldn't replicate spasms or leakage. Months later I had the study done again and it DID show spasms and leakage when my bladder gets about halfway to capacity. A negative or "unconfirmed" test result really doesn't mean much here, but a positive result can tell you a lot.

I got referred to a nephrologist to get anything terrible ruled out so I'm glad I saw the primary. The doc thinks it could be auto immune related or diabetes since I have a family history of both. Going straight to the urologist would of been a bad idea.

foxxybox said:

I got referred to a nephrologist to get anything terrible ruled out so I'm glad I saw the primary. The doc thinks it could be auto immune related or diabetes since I have a family history of both. Going straight to the urologist would of been a bad idea.

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My incontinence is caused by my diabetes. If I hadn't gone to the docctors about becoming incontinent I would never have found out I was diabetic.

If you have oab like symptoms, it is always a good idea to see a doctor, PCP or Urologist. I waited over three years to reveal my issues to my pcp. I only did it with urging from a close family friend who is a nurse. My wife had talked to her with my permission although now I'm good with anything medical being discussed between them about me. I wore a diaper and plastic pants to that first visit about it. The pcp sent me to a urologist who scheduled me for a urodynamics test. The test revealed 3 issues. However I had side effects from the medicine prescribed, called the doctor and stopped taking the pills. The doctor prescribed another pill which I won't take. With other issues, a couple of them major, the doctors had me taking close to a hundred pills a week. Unless its a maintenance med, I'm not taking more pills and I'm slowly getting the number of pills down. All those pills meant a lot of side effects. After the side effects popped up from her pills, I told the urologist I totally prefer diapers and pants to any more pills. At the same time should my issues get worse I can see the doctor who is familiar with my issues. Not sure if this helps your situation, but medical attention is good when you don't know what's going on.

foxxybox said:

I got referred to a nephrologist to get anything terrible ruled out so I'm glad I saw the primary. The doc thinks it could be auto immune related or diabetes since I have a family history of both. Going straight to the urologist would of been a bad idea.

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if the urologist thought there was anything wrong with your kidneys he'd have sent you to a nephrologist too. Unless your primary already had reason to suspect kidney problems, referring to a nephrologist as a first line for bladder problems makes absolutely no sense. I'd be looking for another primary.

The diabetes thing too...he can confirm with a blood test. Either do two blood tests and see if both are over 125 or just skip and do an A1C. I'd be wary of any doctor that "thinks it could be diabetes" but doesn't order the simple blood tests which would confirm it in a day.

I wasn't trying to be argumentative but it's simply not true that you HAVE to see a pcp/gp first. Most GP's are internists or general practitioners and really don't know much about specialized care and will often send you to a specialist anyway. If you have a high deductible health plan, this can mean an expensive and completely wasted appointment.

Anyway the more important point here is really just to get your ass to a doctor, any doctor, if you start having continence issues as it's almost always the sign of an underlying condition ranging from fairly benign nuisance conditions like OAB to major problems like cancer. Ignoring any change in normal function is dangerous.

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ST50 said:

My incontinence is caused by my diabetes. If I hadn't gone to the docctors about becoming incontinent I would never have found out I was diabetic.

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My primary does standard blood work every year during my physical. I have diabetes and that's how it was caught. Suddenly this year my blood sugar on the basic metabolic profile was 130. He had me come back in 2 weeks to repeat. It was about the same.

Do you guys not have standard blood work done on a yearly basis? If not, I'd be looking for a new provider asap.

I did get blood tests ordered. I didn't mean to make it sound like he was so sure of the diagnosis, just some possibilities. The doctors reasoning was the urologist would go straight to more invasive tests when things like me having a white cell count and the auto immune family history would make more sense to go to the Rheumatologist. I should of made that more clear.