Urination Frequency Ranges in Healthy Women

Abstract

Background: Limited information on the normal range of urination frequencies in women is available to guide bladder health promotion efforts.Objectives: This study used data from the Boston Area Community Health (BACH) Survey to (a) estimate normative reference ranges in daytime and nighttime urination frequencies in healthy women based on two operational definitions of "healthy" and (b) compare urination frequencies by age, race/ethnicity, and fluid intake.Methods: A secondary analysis of cross-sectional interview data collected from female participants was performed using less restrictive ("healthy") and strict ("elite healthy") inclusion criteria. All analyses were weighted to account for the BACH sampling design. Normative reference values corresponding to the middle 95% of the distribution of daytime and nighttime urination frequencies were calculated overall and stratified by age, race/ethnicity, and fluid intake. Generalized linear regression with a log-link was used to estimate rate ratios of daytime and nighttime urination frequencies by age, race/ethnicity, and fluid intake.Results: Of the 2,534 women who completed the BACH follow-up interviews, 1,505 women met healthy eligibility criteria, and 300 met elite healthy criteria. Overall, reference ranges for urination frequencies were 2-10 times/day and 0-4 times/night in healthy women and 2-9 times/day and 0-2 times/night in elite healthy women. Women ages 45-64 years, but not 65+ years, reported a greater number of daytime urination than those aged 31-44 years, whereas women 65+ years reported a greater number of nighttime urination. Black women reported fewer daytime urination and more nighttime urinations than White women. Women who consumed less than 49 oz daily reported fewer daytime and nighttime urinations than those who drank 50-74 oz; drinking 75+ oz had only a small effect on urination frequencies.Discussion: Normative reference values for daytime and nighttime urination frequencies were similar in women using strict and relaxed definitions of health. These results indicate a wide range of "normal" urination frequencies, with some differences by age, race/ethnicity, and fluid intake. Future research is needed to examine urination frequencies in minority women and whether fluid intake amount and type influence the development of lower urinary tract symptoms.

Healthy bladder storage and emptying functions in community‐dwelling women measured by a 2‐day bladder health diary

“…Our results differ slightly from a prior meta‐analysis and a secondary analysis of interview data of women participating in the Boston Area Community Health survey on urination frequencies captured using recall and not voiding diaries or other real time assessment 2,9 . In the meta‐analysis, the pooled estimate for daytime frequency was 6.6 times/day and nighttime frequency was 0.4 times/night, with 24‐h frequency being 7.0 times per 24‐h.…”

“…19 These limitations were also noted in a recent systematic review on normative bladder data by Wyman et al where the main source of measurement included bladder diary data. 9 Study limitations include lack of validation of the 2-day diary, nonuniversal response, and the operational definition of nocturia which only measured one night of diary keeping. Based on the VIEW study design, the effect of specific comorbidities, medications, and fluid intake types and volume on bladder function was not assessed, which could impact the findings by over or underestimating healthy bladder functions.…”

“…For example, fluid intake is directly related to urinary frequency and may overestimate unhealthy storage function in the setting of excessive fluid intake. 9 Future study of normative voiding frequency controlling for fluid intake is warranted. Additional limitations to the study include that specific reasons for care seeking and presence of active treatment (e.g., medication therapy for OAB) were not captured.…”

“…In our study, the correlation between Day 1 and 2 on the diaries was strong, suggesting the 2 day diary was sufficient to capture voiding frequency. It is possible, however, that the paper diaries may not have been completed in real time, resulting in recall bias 9,19 . Future studies are needed to determine whether the use of electronic diaries and momentary assessments may improve adherence and accuracy 21 …”

Is Erbium/Neodymium Laser Combination Therapy an Effective Treatment Option for Interstitial Cystitis/Bladder Pain Syndrome With Vulvodynia?

“…VV data showed that our patient had abnormal urine volume owing to pain, but the volume improved and was normal after treatment. In healthy women, the reference range for urinary frequency is 2-10 times per day and zero to four times per night [18]. The urinary frequency in our patient normalized after treatment, which we believe is related to pain improvement.…”