Causes of urinary frequency in palliative care

Urinary frequency is abnormally frequent urination. In patients with palliative care needs, causes include:

• urinary tract infection—may be treated with antibiotic therapy if appropriate (see the Antibiotic guidelines)
• bladder outflow obstruction—due to localised cancer, benign prostatic enlargement or urethral stricture
• reduced bladder capacity—due to localised cancer, external compression (eg faecal impaction, extrinsic tumour) or radiotherapy
• local irritation of the bladder—due to tumour infiltration or treatment-related adverse effects (eg cystitis due to chemotherapy or radiotherapy).

Urinary frequency should be distinguished from polyuria, the passage of an abnormally high volume of urine due to increased production of urine. Treat the cause of polyuria if clinically appropriate. In a patient with palliative care needs, causes of polyuria include:

• hyperglycaemia—see the Diabetes guidelines
• hypercalcaemia—see Hypercalcaemia associated with cancer for management
• diabetes insipidus—see the Bone and metabolism guidelines for management
• heart failure—see Principles of palliative care for patients with heart failure for management
• obstructive sleep apnoea—see the Respiratory guidelines for management
• adverse effects of drugs (eg diuretics).