A compelling need to urinate (urgency), which may feel like almost constant painful straining (tenesmus), can be caused by bladder irritation. Uncontrolled loss of urine (incontinence Urinary Incontinence in Adults Urinary incontinence is involuntary loss of urine. Incontinence can occur in both men and women at any age, but it is more common among women and older people, affecting about 30% of older women... read more 
) may occur if a person does not urinate immediately. Urgency may be caused by a bladder infection Bladder Infection Cystitis is infection of the bladder. Usually, bacteria are the cause of cystitis. A frequent need to urinate and pain or burning while urinating are the most common symptoms. Doctors can often... read more 
. Caffeine and alcohol use may contribute to urgency but rarely cause severe urgency by themselves. Rarely, inflammation of the bladder (interstitial cystitis Interstitial Cystitis Interstitial cystitis is noninfectious bladder inflammation. Interstitial cystitis causes pain above the bladder, in the pelvis, or in the lower abdomen, and the frequent and urgent need to... read more ) is the cause.
Doctors can usually determine the cause of urgency because of the person’s symptoms, the results of the physical examination, and urinalysis Urinalysis and Urine Culture Urinalysis, the testing of urine, may be necessary in the evaluation of kidney and urinary tract disorders and can also help evaluate bodywide disorders such as diabetes or liver problems. A... read more 
. If infection is suspected, urinalysis and urine culture Urinalysis and Urine Culture Urinalysis, the testing of urine, may be necessary in the evaluation of kidney and urinary tract disorders and can also help evaluate bodywide disorders such as diabetes or liver problems. A... read more may be needed. Sometimes, particularly if interstitial cystitis is suspected, doctors may insert a flexible viewing tube into the bladder (cystoscopy Cystoscopy A doctor can diagnose some disorders of the bladder and urethra (for example, bladder tumors, stones in the bladder, benign prostatic enlargement) by looking through a flexible viewing tube... read more ) or do a biopsy of the bladder Bladder biopsy Site-specific biopsies and cell sampling are also used in the evaluation of people with suspected kidney and urinary tract disorders. (See also Overview of the Urinary Tract.) A kidney biopsy... read more .
Doctors treat the cause of urgency.
(See also Overview of Urinary Tract Symptoms Overview of Urinary Tract Symptoms Kidney and urinary tract disorders can involve one or both kidneys, one or both ureters, the bladder, or the urethra, and in men, the prostate, one or both testes, or the epididymis. Problems... read more .)
