The process of urination is provided by the muscular layer of the organs of the lower urinary tract (bladder and urethra), their sphincters. The accumulation of urine to a certain limit and the subsequent outputting of a healthy person is always under the control of the nervous system. The regulation is performed by direct and inverse information coming into the spinal cord along the nerve fibers.
Problems with urination occur when the failure of the mechanism of innervation, dysfunction of the muscles. Clinical manifestations have not only local value, but also cause nervousness, dramatically change the quality of life.
Urination disorder can be divided into:
- frequent urge peremptory character (which cannot be kept by force of will) in the worst case – incontinence;
- pain when urination;
- shortness of urination until acute delay.
The basis of education problems may lie or functional age-related changes. This is more true for children. In adults, impaired urination often associated with disease, moved trauma physical and emotional.
The problem of urinary incontinence
The term “incontinence” refers to the constant drip of urine from the urethral channel. For the patient this is due to issues of hygiene and social maladjustment.
- urethral in connection with involuntary discharge from the urethra;
- Neurocrine – urine comes out through a natural opening, such as via the fistula (vesico-rectal, vesico-vaginal).
In the second case the person does not feel the urge to urinate. It is clear that to treat unearthly type is impossible without surgical intervention. Surgically correct congenital abnormalities and the effects of trauma.
- stress incontinence – occurs when you laugh, a little exertion, cough, any increase in intra-abdominal pressure, worried women with a weakened pelvic floor (pregnancies), men after prostate surgery;
- urgent – are accompanied by hyperactivity of the bladder;
- overflow incontinence is a typical violation of urination in older men with BPH and urinary retention;
- mixed – it’s hard to set a specific species, since there are manifestations of each type is typical for women in postclimacteric period.
The patient is unable to control urination, and defecation. Enuresis or “bed wetting” is more common in boys.
Enuresis can be diagnosed only after the age of three, when the doctor more sure of sufficient functional readiness of the nervous system of the child to ensure control
Surveys have shown that modern children even at the age of seven suffer from enuresis (15%), teen period, all held independently. Further observation noted that, as adults, they have a greater risk of developing diseases of the urinary system. In complicated form it manifests enuresis incontinence in the daytime, dysuric syndrome.
- slow formation of connections of the Central nervous system;
- insufficient production of antidiuretic hormone, disruption of the circadian rhythm of synthesis;
- the inception in the embryonic period malformations of the spinal cord.
Significant importance is attached to early infection of the urinary tract.
Hyperactivity of the bladder accompanied by frequent urging, incontinence. In this case, the violation of urination associated with increased sensitivity of nerve endings (receptors) to the stretching of the detrusor.
The muscle contracts involuntarily, without voluntary control of the person. If the process is accompanied by a neurological disease, it is called neurogenic.
In other cases, the cause is not yet established. Patients do not seek medical attention until there is a persistent incontinence. So to diagnose this problem is possible only by retrospective survey. Urologists believe that the prevalence among the adult population of 10-15%.
Pain during urination
As you can see, the previous problem was accompanied by a unpleasant, but painless manifestations. Usually the pain associated with other symptoms comprising the syndrome of dysuria.
They need to be accompanied by:
- shortness of urination;
- false desires.
The main cause – inflammatory diseases of the lower urinary tract.
- localized above the pubis, and carry the constant pulling;
- cause intense cramps during the act of urination, increase in the beginning or the end;
- to irradiate in the external genitals, perineum, groin.
Sometimes give pain in the lower back
Cystitis and urethritis are more likely to suffer women. Shorter and wider urethra creates an increased risk of Contracting bacterial infection from anus, the genital tract.
Therefore, the most often cause inflammation:
- Escherichia coli;
In the male body the urethral canal longer. This serves as protection from excessive infections.
However, pathogens do.
- with the blood of chronic foci of infection (sinusitis, carious teeth).
- from inflamed prostate.
Considerable importance is unprotected sex.
In the development of inflammation in both sexes must be considered:
- immunity factors (failure in all acute and chronic diseases, diabetes);
- hypothermia pelvic organs and legs;
- moved the procedure catheterization of the bladder;
- the presence of prolonged constipation in diseases of the intestines;
- the development of atony with sedentary lifestyle;
- the abuse of alcohol;
- surgery hemorrhoidal veins.
The problem of urinary retention
Obstruction of the urinary tract most often found in men.
Bad urination is that:
- the patient has much to naturopathica that stood out the urine from the urethra;
- pain when urinating, constant discomfort, a feeling of incomplete emptying of the bladder;
- urine stream is weak, it may split, urine output drops.
In addition, inflammation of the prostate, obstruction of outflow can cause an increase in prostate size hypertrophy and adenoma. It mechanically overrides the urethra, squeezing the urethra.
- irritation of chemical substances (handling of the catheters, the cystoscope);
- diabetes mellitus;
- stones in the bladder;
- complications of traumatic injury;
- prostate cancer;
- the defeat of the nervous regulation in stroke, head injuries and spinal cord;
- unprotected casual sexual relations;
- congestion in the pelvis with circulatory failure.
Prostatitis often occurs in men who previously suffered from sexual infections
The initial symptoms of prostatitis are:
- broken an erection;
- weakening of the urine stream in the morning.
Male-specific diseases that contribute to urinary retention, serve inflammation:
- of the testicles (orchitis);
- the foreskin and glans penis (balanitis, balanoposthitis);
- the epididymis (epididymitis).
What are the typical reasons for women?
- overdose of diuretics they are often trying to make the overweight women to lose weight;
- long-term administration of oral contraceptives, at the first sign of voiding problem should be discussed with the gynecologist;
- increased load on kidney and compression of the bladder during the second half of pregnancy.
What is acute urinary retention?
The lack of timely treatment leads to acute retention of urine, caused by sudden spasm of the sphincter of the bladder neck. The blockage can cause pus, blood clot, stone.
The patient has:
- sharp suprapubic pain;
- the radiation of pain in the lower back and upper abdomen;
- independently palpable enlarged, blubber education;
- urine departs drops or absolutely stands out.
Due to the severity of the condition and excitement a person has seen common symptoms:
- increase in blood pressure;
- pain in the heart and arrhythmia;
- the fever with chills;
- the urge to defecate.
How to identify the main cause?
Problems diagnosis urination begins with a reference to the district physician and the implementation of mandatory blood and urine that can identify inflammation in the bodies of rochevilaine. The results of the research, the therapist will prompt to what expert it is necessary to apply.
You need to be prepared for what you will need:
- inspection and survey of women at the gynecologist;
- consult a neurologist;
- direction to the venereal diseases.
In determining the nature of the incontinence the physician needs to identify anatomical and psychological characteristics of the patient’s complaints. Has the value of establishing sufficient contact for a Frank conversation about intimate issues.
- frequency of urination;
- ago all of a sudden.
- characteristics of the urine stream;
- factors causing disorder;
- possible sexual disorders;
- enuresis in children;
- connection of pain with the act of urine;
- the presence of blood in the urine;
- regularity of defecation;
- previous treatment;
- tolerability of drugs.
Palpation of the anterior abdominal wall was performed to detect tumors, changed skin sensitivity. In men, the urologist must inspect the penis and the prostate palpated through the rectum. During palpation of the study evaluated reflex contraction of the anal sphincter. This allows you to judge the preservation of pelvic reflexes.
Women have important violations are identified by the gynecologist:
- pelvic organ prolapse (uterine and vaginal);
- unusual tone perivaginal muscles.
Palpation of the bladder and urethra is performed through the anterior wall of the vagina. The presence in the urine white blood cells, bacteria, pus, pathogens of sexually transmitted infection confirms the opinion of the inflammatory nature of the problem. Ultrasound – to detect residual urine in the bladder.
Zistografii – the bladder need to do at rest and during strenuous abdominal wall.
- disorders of the cervical part of the bladder;
- changes at the top level of the urethra;
- the degree of stretch of the bladder.
Meccinna cystourethrography – helps detect:
- mechanical obstacle to the outflow of urine;
- to identify a diverticulum of the urethra;
- to fix vesicoureteral reflux.
Cystometry – provides an opportunity to assess the functional status of the bladder by:
- his sensitivity;
- volume and distensibility;
- the contractility of the detrusor.
You can register the involuntary reduction in hyperactivity. Urethral pressure is measured at rest and during coughing. It is judged on the failure of the urethral sphincter. The most revealing diagnostics using videourodynamics research.
Treatment of disorders of function of urination depends on:
- identified the type of damage;
- the age of the patient;
- accompanying diseases.
Urologists there are three ways of solving the problem:
- the use of drugs;
- surgical treatment.
- special exercises that strengthen the muscles of the pelvic floor, development of the necessary muscle reflex restores the communication of nerve endings;
- bladder training by keeping a constant schedule of evacuation with a gradual lengthening of the intervals.
To medicines used in case of incontinence, are Driptan, Vesical, Spasmex.
In inflammatory diseases, doctors prescribe antibiotics and other anti-inflammatory drugs. If there is a sexually transmitted disease, you will need specific medications. At the time of treatment should stop sex life. Always offered simultaneous treatment of both partners to exclude the possibility of re-infection.
Surgical methods depend on the nature of the problem:
- with acute urinary retention and remove mechanical obstruction (stone, clot);
- the detection of a malignant tumor the question of the indications for cystectomy (bladder removal) and the creation of artificial urinal;
- sling surgery is usually performed to women with stress incontinence –strengthens the urethral sphincter is a loop of their own or synthetic fabrics;
- when pelvic organ prolapse, using plastic methods of strengthening the muscles, it contributes to the retention of urine and create enough pressure in the urethra;
- rarely establish the artificial sphincter.
Children with enuresis prescribed dosage drugs in accordance with weight and age.
Antispasmodics to include: Platifillin, no-Spa, Nikoshpan. For treatment of prostatitis, the doctor will prescribe a special anti-inflammatory drugs, drugs that reduce the growth of the prostate tissue. If the delay associated with the tumor, the patient is offered after a course of unsuccessful therapy operative resection of the prostate.
Removing stone from the bladder depends on its size. With a small diameter is recommended cystoscopically option with the special hardware with the capture properties. With a significant size by surgery carried out the autopsy the cavity of the bladder.
Stone removal from the bladder is one of the treatment options
Patients with the disorder of the pelvic organs daily recommended sedentary warm bath, long compresses on the suprapubic area. Here is main treatment focus of hemorrhage or ischemia in the brain.
Is there prevention of urinary problems?
Preventive actions can prevent not only your illness, but the suffering of children.
- For the prevention of incontinence and proper formation of the individual child expectant mothers should take a responsible approach to bearing fruit, his regime, nutrition.
- At a young age to dress for the weather, avoid hypothermia of the legs, pelvis.
- Sex education requires the responsibility of adults and experienced people for the familiarity of adolescents with contraceptives, reproductive health.
- You shouldn’t take any medications, dietary Supplements, succumb to advertising tricks.
- The General strengthening of the immune system, exercise helps to avoid age-related problems.
Voiding can not be left without treatment. The process quickly moves into a phase of neglect. This disease can be treated hard and long, significantly reduced the chances of a successful surgery. Therefore it is better to consult a doctor upon detection of initial signs.