Feeling like you have to pee but little or nothing comes out is usually a symptom called “urinary urgency,” and it has several common causes ranging from minor irritation to infections or bladder conditions.

Common benign causes

• Irritation of the bladder or urethra from concentrated urine (not drinking enough water), caffeine, alcohol, spicy foods, or some medications can make the bladder “twitchy” and trigger false signals that you need to go.

• Stress and anxiety can increase body tension and awareness of bladder sensations, so small amounts of urine in the bladder feel like an urgent need to pee.

Infections and inflammation

• A urinary tract infection (UTI) is one of the most common reasons for a constant urge to pee with only a little coming out; this often also causes burning, pelvic discomfort, or cloudy/strong-smelling urine.

• Other inflammatory bladder problems, such as interstitial cystitis, can cause frequent, urgent urges to urinate even when the bladder is not very full.

Bladder and nerve issues

• Overactive bladder happens when the bladder muscle contracts too often or sends signals too early, so you feel “I really have to go” even though there is not much urine inside.

• Nerve problems (for example from diabetes or spinal issues) or pelvic floor muscle dysfunction can confuse the signals between the bladder and brain, creating urgency or a feeling of incomplete emptying.

When to seek urgent care

• Go to urgent care or an emergency department immediately if:
  • You cannot pee at all and your bladder/pelvis feels very full or painful.

* You have fever, back or side pain, nausea, or feel very unwell along with urinary symptoms, which can mean a more serious infection.

Practical next steps

• If this is new, getting worse, or has lasted more than a day or two, contact a doctor or clinic for a urine test to check for infection and other causes.

• Until you are seen:
  • Drink enough water so your urine is pale yellow, but do not chug huge amounts at once.
  • Avoid caffeine, alcohol, and very acidic or spicy drinks/foods, which can worsen urgency.

* Do not hold urine to the point of pain, but also try not to go “just in case” every few minutes, as that can train the bladder to feel full sooner over time.

If you tell your age, sex, and how long this has been happening, along with any pain, burning, or fever, a more tailored explanation and checklist for what to do next can be provided, but this symptom always deserves discussion with a healthcare professional.