Can Thrush Cause Urinary Urgency?
Yes, thrush (candidiasis) can cause urinary urgency, but this occurs through an indirect mechanism—urinary incontinence leading to perineal thrush, rather than thrush directly causing urgency symptoms.
The Relationship Between Incontinence and Thrush
The connection works in the opposite direction from what the question implies:
Urinary incontinence causes perineal thrush, not the other way around. When patients experience urinary incontinence, the constant moisture and urine exposure in the perineal area creates an ideal environment for Candida growth 1.
The American Heart Association's stroke guidelines specifically identify urinary incontinence as a risk factor that "can increase the incidence of dermatitis, skin breakdown, UTIs, and perineal thrush" 1.
Why Thrush Doesn't Directly Cause Urgency
Thrush is not listed among the recognized causes of urinary urgency in any major urological guidelines:
The primary causes of urgency include overactive bladder (OAB), interstitial cystitis/bladder pain syndrome, neurological disorders, bladder outlet obstruction, overflow incontinence, and urinary tract infections 2.
Urgency is defined as "a sudden, compelling desire to pass urine which is difficult to defer" and represents a bladder storage dysfunction, not a perineal or external genitourinary condition 1, 2.
The Clinical Sequence
The typical clinical progression is:
- Urgency develops first from bladder dysfunction (detrusor overactivity, neurogenic causes, or other bladder pathology) 1, 2
- Urgency leads to incontinence in many patients 1
- Incontinence creates perineal moisture and skin breakdown 1
- Perineal thrush develops as a secondary complication of the chronic moisture exposure 1
Important Clinical Caveat
If a patient presents with both urgency symptoms and thrush, evaluate for urinary tract infection (UTI), as UTIs can cause both urgency and create conditions favorable for candidal overgrowth 1, 2.
Historical literature noted associations between glycosuria and vaginal thrush in pregnancy, but this relates to vaginal candidiasis, not urinary urgency 3.