What is urinary tenesmus (a feeling of incomplete bladder emptying)?

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From the Guidelines

Urinary tenesmus is a symptom characterized by a feeling of incomplete bladder emptying, often accompanied by pain or discomfort in the lower abdomen or urethral area, and is commonly associated with interstitial cystitis/bladder pain syndrome (IC/BPS) as described in the AUA guideline for the diagnosis and treatment of IC/BPS 1. The sensation of urinary tenesmus can be distressing and may significantly impact a patient's quality of life. According to the AUA guideline, patients with IC/BPS often report symptoms of pain, pressure, and discomfort related to bladder filling, as well as urinary urgency and frequency 1.

  • Key characteristics of urinary tenesmus include:
    • A feeling of incomplete bladder emptying
    • Pain or discomfort in the lower abdomen or urethral area
    • Urinary urgency and frequency
    • Symptoms that worsen with bladder filling or improve with urination It is essential to note that urinary tenesmus can be a symptom of various underlying conditions, including urinary tract infections, interstitial cystitis, bladder stones, prostate issues in men, or pelvic floor dysfunction.
  • Treatment of urinary tenesmus depends on identifying the underlying cause, which may involve:
    • Antibiotics for infections
    • Anti-inflammatory medications
    • Alpha-blockers to relax the bladder muscles
    • Symptomatic relief measures such as warm compresses, increased water intake, and avoiding bladder irritants like caffeine, alcohol, and spicy foods. Given the potential impact of urinary tenesmus on quality of life, it is crucial to seek medical evaluation promptly if experiencing this symptom, as it could indicate a condition requiring specific treatment 1.

From the Research

Definition of Urinary Tenesmus

Urinary tenesmus refers to a feeling of incomplete bladder emptying. This symptom is often associated with other lower urinary tract symptoms, such as hesitancy, straining to void, and diminished stream 2.

Characteristics of Urinary Tenesmus

Urinary tenesmus is a symptom that can occur in both men and women, and its etiology is often multifactorial 2. It can be a symptom of underactive bladder (UAB), a condition characterized by a slow urinary stream, hesitancy, and straining to void, with or without a feeling of incomplete bladder emptying 3, 4.

Key Features of Underactive Bladder

The key features of underactive bladder include:

  • Slow urinary stream
  • Hesitancy
  • Straining to void
  • Feeling of incomplete bladder emptying
  • Storage symptoms, such as nocturia and urinary frequency 3, 4

Diagnosis and Management of Urinary Tenesmus

The diagnosis of urinary tenesmus is often based on patient symptoms and medical history 5. Management options for underactive bladder, which can include urinary tenesmus as a symptom, are limited and may include clean intermittent catheterization, neuromodulation, and other therapies 4. However, more research is needed to develop targeted therapeutic interventions and validated diagnostic questionnaires for underactive bladder and urinary tenesmus 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Voiding dysfunction: definitions.

Current opinion in urology, 2001

Research

Definition and symptoms of underactive bladder.

Investigative and clinical urology, 2017

Research

Female underactive bladder - Current status and management.

Indian journal of urology : IJU : journal of the Urological Society of India, 2019

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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