I go much more frequently than the 4-6 and it isn't an issue for me. Everytime I sit down to pee (woman), I usually empty the pouch too. I was told by a Cleveland Clinic surgeon that it's very normal for women 'my age'. I do get up once, often twice per night. Again, it just feels normal for me. I think we all find our normal. (But then I find I can get concerned if I'm going more frequently and I equally concerned if it's less...crazy!)