To address the question what it is you should refer to the original source, namely, the Greek and Latin, the prefix “diz”. It is on these linguistic foundations builds medical terminology. It turned out that the ancient Greeks so meant all the bad, difficult, and in the Latin version – the lack or absence.
A common interpretation of the term “dysuria” in medicine. Some believe that correct way to name only known to dysuric syndrome, others that it is suitable for all urinary disorders.
It turns out that in connection with the urine (Uria) may call dysuria any man’s discomfort with urination: difficulty, frequent, painful and so on.
- accompany almost all urological diseases;
- it occurs when pathology of the nervous system;
- may have a functional nature.
We will look at the most common violations, but first let us recall the rule.
What are the objective indicators defined by normal urination?
The study of physiological functions of the bladder showed that:
- the filling lasts for 2-5 hours;
- frequency of urination (emptying) of sufficient 4-7 times, mostly during the daytime;
- the process of urine output lasts an average of 15-20 seconds;
- in women the urine comes out at a rate of 20-25 ml per second, and for men 15-25.
On the basis of the measurement of these indicators during diagnosis is confirmed by the objectivity of the dysuric phenomena.
The muscular apparatus responsible for the bladder stretch during filling and sufficient force when pushing in the urethral canal are:
- the detrusor;
- the inner and outer ring of the sphincter of the cervix.
The flow of the ureters occurs freely in a low tone of the detrusor, but the high – zamechatelnogo apparatus. The closing mechanism of the neck is the concerted action of the fibers of the detrusor muscle and the initial division of the urethra. When the bladder is filled, the muscles tense, withdrawn the neck of the bladder and block the lumen of the urethra. This creates pressure in the urethra is 10-12 times higher than in the bladder.
The first urge to urinate occurs if accumulated 100-150 ml of urine, its people able to put down
Uncontrollable urge (imperative) appears during the filling of a bubble in 250-350 ml. of This indicator. It is determined by regulatory mechanisms. For example, in children of sufficient neural network develops only to three-year age and later, so the child can’t control urination. The maximum amount depending on the properties of the tissue wall may be 1 l or more.
The act of urination is accompanied by contraction of the detrusor against the background of increasing intravesical pressure and reduced tone of the sphincter. Normal urination causes complete emptying of the bladder. After the cessation of receipt of urine in the urethra muscle the external sphincter is reduced, and the detrusor relaxes. This mechanism covers the opening of the urethra.
The types and manifestations dysuric disorders
Types of desuri vary:
- from disorders of urination;
- accumulation of urine;
- combined mechanisms.
Changes can be caused by pathological processes in the lower urinary pathways and the violation of regulatory functions.
In clinical practice, the most frequent following symptoms:
- frequent urination;
- inability or difficulty when attempting to urinate;
- cramps, burning, pain in the urethra;
- urinary incontinence;
- frequent night urination in the toilet;
- the accumulation of urine in the bladder that causes pain over the pubis.
The causes of these disorders are somewhat different in individuals of different sexes.
Peculiarities of ischuria
Ischuria (urinary retention) causes acute or chronic accumulation of urine in the bladder up to a liter or more. It is connected with impossibility of independent urination. In this form of dysuria in the acute form patients experience dramatic urgency, suprapubic pain.
In chronic ischuria urination may be accompanied by a delay in the bladder a significant amount of residual urine. The patient has incomplete emptying.
The formation of paradoxical ischuria, state when of overcomplete bubble dropwise continuously excreted urine
This dysuria is called “overflow incontinence”. The cause of ischuria is a combination of atony of the detrusor and sphincter of the urethra.
A pathological condition arises:
- with increasing resistance to the flow of urine;
- reducing contractility of the detrusor.
The main pathology that causes acute and chronic latency:
- mechanical obstruction in the cervical part of the bladder, in the urethral canal, dysuria in men is often when squeezing the prostatic hyperplasia, phimosis, cancer in both sexes is in violation of patency in relation to hardening and scarring, adhesions, stone;
- dystrophic and sclerotic changes of the bladder wall on the background of chronic cystitis, increased resistance in the urethra, dysfunction;
- neurogenic disorders, accompanied by atony of the detrusor or increased tone of the sphincters.
Dysuria of this kind is possible with organic or functional changes.
To organic are:
- trauma with damage;
Among the functional are more common:
- the postoperative period and the effects of anesthesia;
- the unusual position of urination for patients who are forced to go on bed rest;
- alcoholic intoxication;
- mental disorders in hysteria;
- the consequence of the negative actions of drugs (Atropine, ganglionic).
Dysuria if hypoactive detrusor
Option dysfunction of the bladder associated with impaired emptying, is considered to be a reduced contractility of the detrusor muscle (underactive). Because of this, a phase selection does not fully emptying the bladder.
In patients with this pathology during the filling of the marked drop in sensitivity of the nervous receptors. As a result, the urge to urinate occurs later than normal. Urine is difficult, the process of connecting the abdominal muscles. Similar pathology often occurs in neurological diseases.
Defeat innervation at any level can cause dysuric disorders
Stranguria refers to the process of difficult urination that requires effort of the patient. Bladder emptying should be possible, but urine is excreted very slowly, drop by drop. The characteristic delay in the start of urination for 30-60 seconds.
Dysuria of this kind may be accompanied by:
- mandatory impulses;
- a burning sensation.
- with impaired patency of the urethra in connection with adhesions, trauma;
- diseases of the prostate gland (prostatitis, adenoma, cancer);
- tumor of the bladder, located in the area of the neck;
- stones in the cavity of the bladder.
Frequent urination is called pollakiuria. This means that a person is forced to urinate more than 7 times a day (there are cases – 15-20 times). Dysuria may be due to enhanced separation of urine in polyuria. Then each portion is considerable in volume, and during the day, diuresis higher than 1.5 L.
Often associated with inflammatory diseases:
Found in urolithiasis, disorders of bladder function.
It is important that, although the amount of each reduced portion of the urine, daily diuresis does not exceed normal
One of the varieties – nocturia or nocturia – urination occurs at night, in small portions. Accompanies diseases of the prostate in men.
Incontinence is defined as involuntary leakage of urine that occurs without urge.
Dysuria with incontinence can be:
- neurocranial (“false”) – not urine flows from the urethra, there is abnormal development of pathways connecting the bladder in girls with vagina, is more common in children; the other option – the consequences of injuries, fistula between the ureter and the rectum, vagina.
In unilateral anomaly or fistula ureteral-vaginal-type matched normal urination with incontinence. If the fistulous course from the bladder goes, it comes complete incontinence.
Types of urethral incontinence is divided into 5 types. Urgent – associated with the sudden uncontrollable urge. The main reason – severe overactive bladder. It may be associated with neurological disorders (neurogenic), and other cases belong to the idiopathic species. The term “symptomatic hyperactivity” is used in the presence of any urological disease.
Another physiological disorder in urgent dysuria due to atony (relaxation) of the urethra. The mechanism observed in the elderly. Stress – occurs when coughing, laughing, running and other situations of increased intra-abdominal pressure. The reason is the mobility of the bladder neck and urethra. Women have a connection with the omission of the vaginal walls.
With stress incontinence, there is no stretching of the detrusor
Another reason is the failure of the external sphincter of the urethra (congenital character or after trauma, surgery, radiation exposure, damage in the sacral section of the spinal cord). Incontinence is called overflow involuntary leakage of urine because the bladder is too stretched. Often find reduced activity of the detrusor. Observed in neurological pathology, trauma in the presence of large surgical interventions in the pelvis.
Mixed incontinence is a combination of urgent and stressful forms. Transient incontinence is considered to be incurred temporarily (constipation, alcohol, medications), and going after the action provoking factor.
Enuresis (bedwetting) is characterized by the absence of conscious perception of the urge to urinate. There is no braking process. In children due to immaturity of functional neural connections. The older persons it is necessary to identify pathological changes.
Diagnostic methods for detecting species of dysuria
Dysuria is not an independent disease, but its symptoms bring patients painful disturbances, experiences, significantly reduce quality of life. It is therefore important to identify the cause and begin treatment.
The set of tests included:
- consultation of the urologist, for women the gynecologist, if necessary, a neurologist;
- General analysis of blood;
- blood for biochemical tests;
- urine analysis with sediment microscopy;
- urine analysis according to Nechyporenko;
- the detection of bacteriuria needed tank. urine;
- isotope uroflowmetry.
The method of treatment depends on the causes. Some species will require special daily exercises, dieting, drinking regime, plan a visit to the toilet. In the presence of inflammation prescribe a course of Antibacterials, antiviral, or antifungal medications, specific drugs for tuberculosis, sexually transmitted infection.
Mechanical damage, fistulas, adhesions require surgery. The method and scope of the operation specified by experts. Tumor growth can be treated conservatively with radiation therapy, chemotherapy drugs. For conservative pain and relieve spasm use rectal candles with Benzocaine, Papaverine, belladonna extract.
In case of dysuria, you need to consult a doctor. A specialist should discuss and possible folk remedies. Self-treatment is ineffective, only delays and aggravates the symptoms.