Six bladder symptoms you should never ignore, according to a urologist

Going for a wee is one of those things many of us do without paying it a second thought. But keeping tabs on your wee – including how often you visit the toilet – is a great way to monitor your bladder, kidney and liver health.

Most of the things you spot will likely be harmless. “Most bladder symptoms are caused by common, treatable conditions,” explains Dr Masarat Jilani, a genitourinary health expert and in-house GP at the bladder health supplement brand Jude. “But because some symptoms can overlap with more serious problems, it’s important not to dismiss some key changes in your urinary habits.”

As with all areas of your health, a bit of common sense is key. For example, if you’ve drunk lots of water, consumed more alcohol or caffeine than usual or are under a lot of stress, then it’s normal to notice changes in the colour of your wee, how often you go to the toilet and how urgent your need to go is.

But there are some symptoms you should never ignore (especially when there are no obvious causes), and being aware of them can help you work out when you need to speak to your GP. Here’s what to look out for.

Blood in your wee

You probably don’t need to be told that blood in your urine isn’t a good sign, and it’s definitely something you should never ignore. Blood in the urine can look red, bright pink or dark brown; as soon as you spot it, you should book an urgent GP appointment or call NHS 111 for more information.

“Up to 20 per cent of patients who have visible blood in their urine will have some kind of urological cancer (cancer which affects the urinary system, including the bladder and kidneys), so if you notice a change, go to your doctor,” advises Mr Bijan Khoubehi, consultant urological surgeon at London Urology Specialists.

Blood in the urine – also known as hematuria – can also be triggered by other causes such as kidney or bladder stones, autoimmune diseases like Berger disease, an enlarged prostate and taking blood thinners.

But because early detection of urological cancer improves survival rates and expands treatment options, speaking to your doctor to rule out cancer should always be your first port of call.

A burning sensation when you go

A burning sensation when you go to the toilet is a sign that your bladder or urethra (the tube which carries wee out of the body) is irritated. A common cause of this kind of discomfort is a UTI (urinary tract infection).

While antibiotics aren’t always needed to treat a UTI, they are required in many cases, so it’s not something you can ignore and hope it goes away.

Women and girls aged 16-64 can get help or advice from a pharmacist (if you’re not pregnant or breastfeeding), but it’s recommended that men, children, pregnant women and the elderly all book in to see their GP.

Jilani points out that there are other potential causes of a burning sensation when weeing, such as some STIs, vaginal and prostate infections, and interstitial cystitis (also known as bladder pain syndrome). Booking an appointment with your GP is the best way to get to the bottom of what’s going on.

Feeling a strong urge to wee out of nowhere

Keep finding yourself rushing to the toilet out of nowhere? While it’s normal to experience the odd case of urgency when you’ve drunk a lot of caffeine or are feeling stressed or anxious, having to rush to the toilet without warning on a regular basis is something that warrants investigation.

“You should always see a doctor about urgent urination if it is a new symptom for you or if it has changed in any way, particularly if it is affecting your daily activities or causing accidents,” Jilani says. “Urgency that comes with pain or blood in the urine needs an urgent assessment.”

In some cases, urgency can lead to “urge incontinence”, where you’re not able to make it to the toilet in time because the need to wee comes out of nowhere. This is different from stress incontinence, which usually affects women who have had a vaginal birth, and can be caused by everything from UTIs to bladder stones. In men, it’s commonly caused by an enlarged prostate, a non-cancerous condition often found in men over 50.

Dr Jilani adds that if you’re suddenly experiencing urgency or urge incontinence accompanied by back pain, then you need to visit A&E. These can be signs of a life-threatening condition called Cauda Equina Syndrome, where the nerve roots at the base of the spine become compressed.

Constantly needing to wee again soon after you’ve gone

This can be a sign of something called “incomplete emptying”, where the bladder doesn’t fully empty when you go to the toilet. The only way to formally identify this is via a scan, but Khoubedi says a common sign of incomplete emptying is needing to go to the toilet 10 to 15 minutes after your last visit.

It’s much more common in men than women, because it is commonly caused by an enlarged prostate. However, because incomplete emptying can also be a symptom of prostate cancer, Khoubedi recommends getting it checked out. “It’s not a ‘visit your doctor today’ scenario like visible blood or a burning sensation, but I’d suggest booking an appointment if you notice it continues for more than a day or two.”

Women who experience incomplete emptying should also consider a trip to their GP: it can be a sign of pelvic floor dysfunction or pelvic organ prolapse.

Waking more than once in the night to wee

Many of us worry that needing to go to the toilet in the night is a sign that something is wrong, but it’s totally normal to wake up and need a wee, especially when you’ve drunk lots of liquid close to bedtime and as we get older.

Going to the toilet more than this is something you should keep an eye on – but only under specific circumstances. While experts typically say two or more times a night is a sign of a problem, Khoubedi recommends taking that advice with a pinch of salt.

“I’ve got patients in their seventies who now wake up three or four times a night, but it’s gradually gone up from when they were in their fifties,” he says. “On its own, it’s not necessarily a red flag.”

Of course, if you suddenly find yourself needing to get up to go to the toilet three or four times every night, or feel as if you can’t empty fully when you do go, then speaking to your doctor should be your next move.

And if you’re finding that needing to wee at night is having a huge impact on your ability to sleep well, that’s also a cause for concern. After all, getting enough good-quality sleep has been linked with everything from a reduced risk of dementia to better mental health, so it’s not something to be sniffed at.

Your doctor may be able to recommend lifestyle changes or prescribe medications that help to reduce the number of times you wake up.

Complete inability to go

Not being able to wee at all, even though your bladder is full, is a medical emergency; Jilani recommends going to A&E straight away.

Officially known as urinary retention, it can be caused by physical blockages and nerve damage. But no matter what you think the cause may be, it’s something you should get seen to at once.