Violation, urinary infections in children, causes, symptoms and treatment. What does dysuria look like, what are its symptoms? The most common methods include

Various kidney diseases are a very common phenomenon in the modern world. The crazy rhythm of life, malnutrition, hypothermia and stress provoke pathologies of the urinary system.

One such disease is dysuria. It is, rather, not a disease, but a syndrome in which there is difficulty urinating. What is this syndrome - dysuria, we will consider in more detail later in the article.

The essence of the disease and its forms

Dysuria is a violation of the process of urination, manifested in painful urination, spontaneous ejection of urine, insufficient emptying of the bladder.

This term denotes all problems with diversion of urine. ICD code 10 - R 30.0. The disease occurs in men, women and children at any age.

Pathology manifests itself in the following forms:

. Involuntary, uncontrolled excretion of urine without urge, divided into true and false.
pollakiuria. Increased excretion of urine in small portions. There is constant, day and night.
. Sudden discharge of urine after urging.
Stranguria. Difficulty urinating, accompanied by pain and a feeling of incomplete emptying of the bladder.
Ishuria. The impossibility of self-diversion of urine.
Painful urination.

Dysuric syndrome is accompanied by other pathological manifestations: fever, pain in the organs of urination, pain in the lower abdomen, cloudy urine.

Causes of the disease

The causes of dysuria are common for men and women. Also, representatives of both sexes have specific causes of the disease.

General:

Specific causes of male dysuria are: tumors, tumors of the urethra, phimosis.

Causes of female dysuria Key words: pregnancy, natural childbirth, menopause, genital tumors, uterine prolapse, endometriosis.

In children, involuntary urination in the absence of diseases up to 5 years is considered the norm.

At an older age, the reasons may be:

tumors in the pelvis;
phimosis;
infections;
tuberculosis of the genitourinary system;
neurological causes (stress, fear).

Characteristic symptoms of dysuric disorder

Symptoms of the disease pronounced and are characteristic for men and women:

Women may additionally experience pain and cramps in the genital area and lower abdomen.

The appearance of at least one of these symptoms is a serious reason to see a doctor.

How is the disease diagnosed?

To diagnose pathology, a number of laboratory and instrumental studies are carried out.

First, the doctor conducts a survey of the patient on the subject of previous and existing diseases, injuries. Then they find out what symptoms the patient has, how long ago they appeared. Women must undergo a gynecological examination to exclude tumors of the pelvic organs, endometriosis. In some cases it is shown neurologist consultation.

Then the necessary tests are prescribed:

General analysis of blood and urine.
Blood chemistry.
Urinalysis with sediment microscopy.
. Identifies the causative agent of the inflammatory process in the genitourinary system.

Mandatory instrumental research:

Using these methods, stones, structural changes in organs are detected.

Additionally apply:

Urethroscopy in men and cystoscopy in women, i.e. the introduction of a probe through the urethra for examination from the inside.
Comprehensive urodynamic study (CUDI) - attaching sensors to the skin of the perineum. Determine the acts of the urinary organs.

How to treat?

The treatment of the disease should be approached responsibly and started immediately. Since the disease is a consequence of serious diseases, it can significantly worsen the quality of human life.

The disease will become chronic, irreversible changes will occur.

Therapy of pathology depends on the cause that provoked it. Apply conservative and surgical treatment. Conservative treatment includes:

Taking antibiotics, antifungal and antiviral drugs for bacterial dysuria.
Hormone therapy for endometriosis and menopause in women.
Taking sedatives, psychotherapy, if the disease is caused by stress.
Reception of drugs that relax the muscles of the walls of the bladder.
Physiotherapy to stimulate muscles and restore their functions.
to strengthen the muscles of the perineum.
Set a bladder emptying schedule to develop the habit of emptying regularly.
Compliance with diet and drinking regimen in diabetes and kidney disease.

Surgical methods:

Prevention

Prevention is simple helps prevent causes that subsequently cause dysuric syndrome:

Treatment of viral diseases.
Injury prevention.
Performing Kegel exercises for women in order to strengthen the muscles of the perineum.
Taking medications only as prescribed by a doctor.
Avoidance of stress.
Regular gynecological and urological examinations.
Analysis of hormone levels during menopause in women.
Adherence to the diet in diabetes and kidney disease.

Treatment of dysuria is a long and complex process. With timely diagnosis and a correctly drawn up treatment plan, it is possible to achieve impressive results and return the patient to a full life.

The doctor will tell about the problem of urinary incontinence in women, as a dysuric disorder, and its solution in the video:

Dysuria is a medical term widely used in urology, which indicates various diseases of the genitourinary and other body systems.

Dysuria is a collective concept in medicine, which includes any disorders of the urinary tract. May be accompanied by painful sensations, frequent / rare urination, a feeling of incomplete emptying of the bladder, false urges, incontinence. According to modern statistics, the frequency of dysuric phenomena in the female population is greater than in the male population. This is due to the structural features of the female genitourinary system. Dysuria in children is equally common among girls and boys.

Reasons for the development of dysuria

Dysuria is not an independent disease, but only a symptom of a physiological or pathological state of the body. Its main causes include physiological and pathological factors. Among the physiological causes are stress, overwork, pregnancy, menopause in women, hypothermia, individual body response to a change in diet or physical activity, alcohol intoxication, in the elderly - weakness of the pelvic muscles.

Pathological causes include:

various diseases of the urinary system (nephritis, nephrosclerosis, tubulopathies, cystitis, urethritis, stones, malformations, neoplasms);
gynecological / andrological diseases (vulvitis, cervicitis, endometriosis, ureaplasmosis, chlamydia, tumors, malformations);
diseases of the nervous system (damage to the central nervous system, impaired innervation of the pelvic organs);
metabolic diseases (diabetes, obesity);
performed surgical interventions;
taking certain medications (diuretics, caffeine can increase diuresis; antidepressants, calcium antagonists, b-agonists can cause fluid retention).

Symptoms of dysuria

Despite the different causes of urination disorders, the main symptoms in patients with this condition can be distinguished:

pain when urinating;
frequent urge, small amount of urine;
involuntary urination;
feeling of insufficient emptying;
difficulty urinating, the causes of this condition in men are possible.

Other symptoms include

itching along the urinary tract;
burning in the urethra during urination;
pathological discharge from the genital tract;
pain in the pubic area, lower abdomen and lower back;
deterioration of health, high body temperature.

The combination of the main and additional symptoms indicates a severe course of the disease.

Forms of dysuria

In connection with the different mechanisms of development of dysuric phenomena, they can be divided into three main groups: impaired accumulation, excretion of urine, and their combination.

In violation of the accumulation of urine, there is an increase in urination more than 8 times during the day (pollakiuria). It is divided into two forms: daytime (with urolithiasis) and nighttime (more often in men with benign prostatic hyperplasia). The second form is associated with an increase in the gland as a result of increased blood supply to the pelvic organs at night.

Ischuria is manifested by the inability to urinate independently. There are neurogenic (smooth muscle spasm) and mechanical (the presence of an obstacle along the outflow of urine - a tumor, a stone). The most dangerous is acute urinary retention, which occurs against the background of complete well-being and is accompanied by fever, chills. As a complication of this process, renal failure may occur.

Urinary retention may be chronic. The patient's condition worsens gradually, going to the toilet does not cause discomfort, but a certain volume of urine remains in the bladder after urination. One of the reasons for this is a mechanical obstruction to the normal outflow of urine.

Stranguria - difficult urination with discomfort, a feeling of incomplete emptying of the bladder. Among the reasons for the development of this condition, the most significant are prostate adenoma (difficulty urinating in the morning), urolithiasis, and neurological disorders.

Pain during urination accompanies many diseases of the genitourinary system and often has an inflammatory genesis. With cystitis, pain is observed at the end of the act of urination. Pain at the beginning of urination can occur with damage to the pyelocaliceal system of the kidneys.

Incontinence is a condition in which urine is passed involuntarily, without an urge. There is a true (through natural ways) and false (through pathological openings or defects in the walls of the urinary tract) incontinence. In turn, it is divided into imperative, stressful, nocturnal.

Imperative incontinence is characterized by an overwhelming urge to go to the toilet.

This condition can develop with an overactive bladder or the presence of acute inflammatory processes in the lower urinary tract (urethra, bladder).

The basis is the weakness of the sphincter and muscles of the perineum. More often, involuntary urination develops in older women and is associated with the prolapse of the vaginal wall, suffered pathological childbirth, and during menopause and menopause - with impaired estrogen formation. This type causes great discomfort to patients, since tension in the abdominal muscles and increased pressure in the abdominal cavity cause urination not only when lifting weights, but during coughing and laughter.

Bedwetting (enuresis) - urination during sleep. The reasons for this phenomenon are stress, detrusor hyperactivity, a "small" bladder, developmental anomalies, untreated pathology of the genitourinary system, side effects or high doses of drugs.

Features of dysuria in childhood

Cases of "wet" nights in babies are not rare. This should not cause much concern for parents. This condition is considered the norm for children under 5 years old - by this time the formation of a conditioned reflex is completed. But if such conditions have become more frequent or difficulty urinating / pain has joined, this may indicate some kind of inflammatory process and is the reason for going to the doctor.

Diagnostics

Dysuric disorders are a symptom of many diseases, so it is necessary to comprehensively approach their diagnosis. Careful collection of complaints, medical history and physical examination help the doctor move in the right direction and choose the best treatment tactics.

Required research:

blood test (general, biochemical tests);
urine for general analysis, bacteriological examination, analysis according to Nechiporenko;
Ultrasound of organs - kidneys and small pelvis (search for pathology of the urinary system);
cystoscopy (visual examination of the walls of the bladder);
intravenous pyelography (used for the diagnostic search for stones, neoplasms, constrictions / expansions, malformations);
isotopic uroflowmetry (used to study the characteristics of the jet);
consultations of narrow specialists - urologist, gynecologist.

In men, if the presence of diseases of the prostate gland is suspected, a digital examination of the prostate, the determination of prostate-specific antigen, and ultrasound of the gland are performed.

Treatment

For optimal selection of therapy, it is necessary to know exactly the cause of dysuria. Treatment should be carried out under the supervision of a physician in order to avoid complications or chronicity of the process. The main aims of treatment are

elimination of the etiological factor;
improving the patient's well-being (remove pain, discomfort, altered urination).

Preference is given to conservative methods of treatment. In the inflammatory process, antibacterial, antiviral or antifungal drugs are used, depending on the causative agent of the disease. It is important to develop a plan for visiting the toilet, drinking regimen, diet (chocolate, citrus fruits, raisins, nuts, coffee / tea, cheeses are excluded).

With the development of complications, the impossibility of conservative therapy, surgical methods are used. Treatment by surgery is indicated in such cases:

neoplasms of the urinary system;
urolithiasis disease;
the formation of fistulous passages;
prolapse of organs;
formation of an artificial urethral sphincter.

No need to hesitate, postponing a visit to the doctor for later! Problems with urination can lead to irreversible processes, the addition of additional diseases, the development of complications, high moral and material costs.

Dysuria is a generalized term for the process of impaired bladder emptying. This is not a disease, but a symptom of a functional or organic disorder in the functioning of the organs of the urinary system. Dysuria can appear both in adult women and men, and in children of different years. More often the disease occurs in older people during periods of hormonal changes. Dysuria has a large number of symptoms, including difficulty passing urine, infrequent or frequent urination.

Classification and manifestations of dysuria

Duziria is classified according to:

violation of the mechanism of accumulation of urine;
difficulty passing urine;
combined disorder.

The development of dysuria can manifest itself in different forms:

pollakiuria. Urination becomes frequent. Allocate pollakiuria depending on the time of day (day or night).
Enuresis. Uncontrollable persistent urinary incontinence without prior desire to void.
Stranguria. Emptying occurs with great difficulty, the patient experiences a pulling pain and a feeling of an incomplete emptying process.
Ishuria. Inability to go to the toilet on their own.
Painful emptying of the bladder. A condition that often accompanies diseases of urology and gynecology.
Incontinence. Uncontrolled release of urine after a sudden urge to empty the bladder.

Studies of the physiological work of the bladder have shown that objective indicators of normal urination are:

the filling of the bladder occurs in 2-5 hours;
Normally, emptying occurs 3-6 times, most often during the day;
the process of urination lasts no more than 20 seconds;
the rate of urine excretion in women is up to 20-25 ml per second, and in men - up to 15-25 ml.

Based on these data and diagnostic results, the development of dysuria is established.

Manifestations of dysuria disorders

Violations in the work of the urinary system can occur as a result of pathological processes in the lower urinary tract, as well as due to a violation of the regulatory function.

The most commonly observed symptoms are:

frequent urge to urinate;
difficulty passing urine;
a feeling of pain, burning or pain in the urethra;
problems with holding urine;
constant visits to the toilet at night;
accumulation of urine in the bladder, which leads to pain above the pubis.

The causes of these disorders are divided into several categories and are associated with different diseases:

Dysuria in men

The most common cause of dysuria in males is compression of the prostate urethra. A constant urge to go to the toilet can be the first sign of prostate problems.

The excretion of urine is difficult. It comes out in a thin stream, which is interrupted, and if the disease is running, then the urine comes out drop by drop. Urine is separated not so intensively, sluggishly, at first the process is accompanied by pain, and later urination becomes longer in time. After the process is completed, there is no feeling of complete emptying of the bladder.

Another reason for the difficulty in exiting urine can be the formation of a tumor in the urination canal, the formation of stones in the urea and a decrease in the internal lumen of the canal.

Female dysuria

In women, dysuria develops as a result of prolapse, prolapse of the uterus, childbearing, the onset of menopause or its onset, and inflammation of the genital organs. This includes endometriosis - the uterine mucosa goes beyond its borders, which is why cysts form.

Women should visit a doctor if the following symptoms appear:

urination began to occur longer than usual;
the stream of urine bifurcates or weakens, pours vertically down;
urine began to splatter.

Manifestations of dysuria in a child

Children usually suffer from acute dysuria resulting from infectious diseases, hypothermia, acute cystitis and phimosis. Dysuria is often accompanied by urinary tract infections, bacteria can enter through the external genitalia and cause the development of the disease.

The disease can be caused by tuberculosis, the formation of tumors in the genital organs, which requires urgent treatment. Confirmation of the diagnosis are complaints of difficulty in urination and the identification of deviations from the norms of tests.

Symptoms of dysuric disorder

Symptoms depend on the process and type of violations in the process of excretion of urine. They are divided into 3 groups:

Frequent trips to the toilet during the daytime, nocturia, difficulty with urinary retention, uncontrolled excretion of urine at night, constant incontinence due to stress.
The stream becomes weak, splashes or splits into several streams, there are difficulties with the beginning of the withdrawal of urine, instillation, discomfort during urination.
After emptying, there is no feeling of completeness of the urination process, there is instillation after going to the toilet.

Some symptoms are accompanied by pain and burning.

Methods for diagnosing dysuric disorder

Although dysuria is not a separate disease, its occurrence gives a person discomfort and disrupts the usual rhythm of life. That is why it is important to identify the cause of this disorder in a timely manner and prescribe the correct treatment.

The diagnostic complex includes:

a visit to a urologist (for women - a gynecological room), in case of urgent need - a visit to a neurologist;
blood analysis;
urine analysis with sediment microscopy;
if bacteriuria is detected - analysis for bacteriuria;
intravenous pyelography;
analysis of urine according to Nechiporenko.

Treatment of dysuria

The course of treatment depends entirely on the true cause of the disease. Some forms of the disease need to be treated with daily special exercises, diet, controlled water intake, adhering to a plan for emptying the urea.

If there is an inflammatory process, then a course of antibacterial agents, antiviral or antifungal agents, special medications for the treatment of tuberculosis and genital infections are prescribed.

Surgical intervention is necessary for mechanical damage, fistulas or adhesions. The resulting tumors can be cured with radiation therapy.

As soon as the first signs of dysuria appear, you should immediately consult a doctor. The specialist will make a diagnosis and prescribe a course of treatment. Sometimes it is carried out with the help of folk remedies. But it is undesirable to be treated on your own, as this can lead to an aggravation of the disease and only increase unpleasant symptoms.

Dysuria or dysuric disorder is a term that combines a group of symptoms and clinically manifest abnormalities that are associated with disturbances in the natural process of urination. These may include difficult, or too much, incontinence or urinary retention in the body. In addition to the frequently occurring signs, there may be separate, rarer, little-known cases with separate symptoms.

Urological and nephrological factors. Dysuria is most typical for infections or tumors of the urinary system: kidneys, bladder, ureters and urinary canals; observed with the occurrence of scars on the walls of the bladder.
Gynecological and andrological factors. Urination disorder can be triggered by diseases of the prostate gland, inflammatory processes, infections or genital organs caused by weakening of muscle tissue in the perineum. Symptoms in women are also observed during pregnancy, premenstrual or menopausal syndrome.
endocrine factors. Dysuric syndrome can occur with diabetes and diabetes insipidus and other endocrine diseases.
neurological factors. Neurological dysuria usually occurs with severe nervous shocks, regular stress, chronic overwork and degenerative diseases of the central nervous system. The action of alcohol and other drugs can also provoke dysuria.
Physiological factors. Urination disorder can be both temporary (during rehabilitation after injuries or surgeries) and permanent (due to chronic diseases, congenital malformations or acquired defects in the structure of the genitourinary system).

Classification

It is characterized by frequent and often painful urination. Most often observed in patients with acute form and urolithiasis, similar symptoms in men are also observed in (benign neoplasm on the tissues of the prostate gland, which often occurs in men after 40 years). In women, frequent urination can occur as a result of gynecological diseases. With pollakiuria, the number of urges to urinate during the day can reach 8 or more times.

More often expressed as a symptom of an obstruction to the outflow of urine, which is possible with adenoma or prostate cancer, or (narrowing of the opening of the foreskin). However, this disorder can also occur with deformities or neurological changes in the structure of the muscular wall of the bladder.

Chronic.

This form of dysuria can lead to decompensation of the bladder wall, which in turn is also a complication after a long difficulty in the act of emptying. At the first stages, urination occurs quite often, but in small portions, then, in the process of developing decompensation, the remains of unextracted urine begin to linger and accumulate in the bladder cavity.

If the cause of the pathology is not identified and eliminated in time, the volume of accumulated fluid increases, which can provoke chronic difficulty urinating. Such an outcome is fraught with a strong violation of the muscle tone of the bladder, and then the function of its sphincter, which inevitably entails a complete lack of the ability to urinate independently.

Then comes a condition in which urine begins to flow involuntarily due to overflow of the bladder, namely, paradoxical ischuria. Such a complex disorder of urination in men occurs with extremely advanced stages of prostate adenoma or with severe lesions of the central nervous system.

Unlike chronic delay, this form of dysuria can occur quite spontaneously and is one of the urgent conditions. The cause of such a disorder can be a large stone in the bladder or ureter, which prevents the process of emptying, trauma or narrowing of the urethra, as well as acute prostatitis.

Among other things, such consequences can be caused by factors such as taking excessive amounts of diuretics, alcohol, spicy foods, abdominal surgery or a sedentary lifestyle.

Incontinence is conditionally divided into true (uncontrolled release of urine through the urethra) and false (outflow of fluid through birth defects in the urinary system). In addition, with infections of the bladder or ureter, urine can enter the body through fistulas or ruptures.

True incontinence is often the result of a violation of the basic functions of the sphincter or detrusor (muscle membrane) of the bladder and urethra.

Doctors also distinguish between urgent (or imperative) and stress urinary incontinence.

Urge incontinence can be one of the symptoms of an overactive bladder or an acute form of inflammation of one of the organs of the urinary system. It is characterized by excessive activity of the bladder wall and is expressed mainly by strong, uncontrollable urge to urinate.
Stress incontinence is a sign of loss of tone in the pelvic floor muscles and bladder sphincter. This form of the disorder can appear in women during menopause due to hormonal imbalance or in old age due to the prolapse of the anterior vaginal wall. It is characterized by involuntary excretion of urine during sudden movements, fast walking, sneezing, coughing, lifting heavy objects, etc.

A separate type of incontinence is (involuntary nocturnal urination), which is the result of the absence of a developed conditioned reflex that suppresses the urge to empty the bladder during sleep. May occur in children, most often boys, and usually resolves completely without medical intervention to the onset of puberty.

Diagnostics

Diagnosis of dysuria is aimed primarily at identifying the form and severity of the disorder, and of course, the true root cause of the symptoms. To begin with, specialists conduct a detailed survey of the patient in order to maximally clarify the duration, frequency and severity of manifestations of the symptoms of the disease, as well as to make a preliminary diagnosis. After systematizing complaints and a general examination, the patient is prescribed the following tests:

(to establish the likelihood of inflammatory processes in the organs of the urinary system).
(to detect possible pathogens of infections that affect the organs of the urinary system).
ultrasound examination of the organs of the genitourinary system (to determine the presence or absence of congenital and acquired pathologies, defects and deformities).
(allows you to get images of the bladder in different projections to study the processes or changes occurring in it).

Women need to undergo a complete gynecological examination in order to detect possible inflammatory or infectious diseases of the genital organs.

With a high probability of neurological disorders, patients are prescribed magnetic resonance or (MRI or CT).

Treatment

The main thing in the treatment of urinary disorders in women and men is the elimination of the root cause, that is, the disease that caused the dysfunction of the bladder or urethra (urethra).

When infections or inflammatory processes are detected, a special diet is usually prescribed, measures to restore the water balance in the body and eliminate pain, if necessary, therapy with the use of anti-inflammatory, antifungal, antiviral drugs.

If we are talking about benign or malignant neoplasms, pathologies and deformities, then surgical intervention may be indicated:

operations to eliminate the tumor;
interstitial injections;
operations to correct the location and fixation of the bladder;
creation of an artificial sphincter;
operations to correct or correct defects in the development of the genitourinary system.

Conservative treatments for dysuria in women and men include:

exercise or electrical stimulation to strengthen the muscles of the perineum and pelvic floor.
a special diet that excludes foods that irritate the flora of the bladder.
development of bladder endurance by establishing a schedule for urination.
sedatives or sedatives (for disorders associated with stress and nervous shocks).
stimulants, regulators, normalizing the work of the organs of the urinary system.
hormone therapy (for incontinence in menopausal women).
the use of devices to support or hold the organs of the genitourinary system in the small pelvis.

Prevention

In order to avoid urination disorders, it is worth carefully monitoring the condition of the organs of the urinary and reproductive systems, in a timely manner, taking all measures to cure inflammatory, infectious and viral diseases.

It is important to control body weight, give preference to an active lifestyle, avoid hypothermia and do not forget about mandatory personal hygiene.

In order to ensure that complications and nervous shocks associated with them are avoided, if any symptoms of the disease appear, do not hesitate and contact a specialist.

Description:

Difficulty or frequent urination.

Symptoms:

Urination disorders (dysuria) are typical, as a rule, for diseases of the lower urinary tract (bladder, prostate, urethra) and are of two main types - frequent and difficult, the latter is often accompanied by urinary retention.

Frequent urination (pollakiuria) can be a physiological condition or be the result of neurological and urological diseases.

With an average diuresis of 1500 ml and a normal bladder capacity of 250-300 ml in healthy individuals, urination occurs 4-5 times during the day and 1 time at night. Its frequency with heavy drinking, cooling or excitement is considered as a physiological phenomenon.

In diabetes or diabetes insipidus, frequent urination is accompanied by a normal or increased volume of urine.

Accelerated many times within an hour, in small portions, of varying intensity, independent of the time of day, occurs in acute cystitis. However, in some diseases, pollakiuria changes its rhythm. So, in patients with prostatic hyperplasia, urination is accelerated mainly at night (nocturnal pollakiuria), which is due to irritation of the sphincter due to a rush of blood to the pelvic organs during sleep and an increase in the volume of the gland. With a bladder stone, on the contrary, nighttime urination is not speeded up, and during the day, when the patient moves and the stone, moving, irritates the nerve endings of the mucosa, it is speeded up. Pollakiuria is often observed in women with prolapse of the anterior wall of the vagina, bending or swelling of the uterus and is associated with circulatory disorders in the bladder neck.

Difficulty urinating (stranguria) usually occurs when there is an obstruction to the outflow of urine - hyperplasia and prostate cancer, stricture, stone or tumor of the urethra, narrowing of the foreskin (phimosis), tumor of the bladder neck. However, it can also occur in its absence in diseases or injuries of the brain or spinal cord. Depending on the nature of the lesion, the stream of urine becomes thinner, its intensity decreases, the act of urination lengthens. The patient has to push, straining the abdominal muscles, waiting for the onset of urination. At the same time, the urine stream is thin, sluggish, often does not describe an arc, falls vertically down. In advanced cases of the disease, urine is excreted drop by drop.

To overcome difficulty in urination, hypertrophy of the bladder muscle (detrusor) first occurs, and contractions of the abdominal muscles and perineum increase. Urination becomes multi-act - the patient releases part of the urine, then after a while he strains again and removes the next portion, etc. With the help of these actions, at first he completely empties the bladder (compensated bladder). However, at a certain stage of the disease, he cannot do this (decompensated bladder) - residual urine appears, the amount of which gradually increases and can reach 1.5 liters or more, i.e. chronic urinary retention (ischuria) occurs.

Unlike chronic urinary retention, which develops gradually, acute urinary retention occurs suddenly and is expressed in the impossibility of emptying the bladder, despite its sharp overflow. The most common causes of it are hyperplasia of the prostate gland, a posterior urethral stone, acute, trauma, much less often - surgery on the pelvic organs, an emotional factor, etc. It is promoted by blood rushes to the hyperplastic prostate gland with constipation or diarrhea, exacerbation. overdistension of the bladder during intoxication.

In women, chronic urinary retention is more often observed with a tumor of the genital organs or the urethra and is associated with compression of the urethra.

In children, acute or chronic urinary retention occurs with phimosis and acute cystitis, when the child refrains from urinating due to pain.

It is necessary to differentiate ischuria from in connection with a symptom common to these concepts - the absence of independent urination. It should be remembered that with ischuria the bladder is full, there is an urge to urinate, but the patient cannot urinate; with anuria, the bladder is empty, there is no urge to urinate.
- a condition in which there is an involuntary outflow of urine through the urethra (true incontinence) or other channels (false incontinence) and can be established visually. The main causes of true incontinence are dysfunction of the detrusor and urethral sphincter, as well as overdistension of the bladder, false - birth defects of the ureter, bladder and urethra, urogenital or ureteric.

There are several main types of true urinary incontinence - imperative, stressful, from overflow, nocturnal.

Imperative (urgent) incontinence - the release of urine in different quantities through the urethra at the height of the uncontrollable imperative (imperative) urge to urinate. These patients at this moment have a feeling that urination is about to begin and any delay may result in urinary incontinence. It can be observed with inflammation of the bladder, especially the cervix, posterior urethra and prostate, as well as hyperplasia of the latter. Detrusor overactivity is the most common cause of urge urinary incontinence.

Stress (with stress) incontinence - involuntary release of urine through the urethra when coughing, sneezing, lifting weights, etc. It is caused by an increase in intra-abdominal and intravesical pressure in patients with insufficiency (weakness) of the urethral sphincter and pelvic floor muscles. It is observed in trauma and tumors of the spinal cord, myelitis, after operations on the rectum, extirpation of the uterus, transurethral endoscopic manipulations, etc. In men, stress urinary incontinence is most often observed after adenomectomy or, which is associated with damage to the urethral sphincter. It can be constant or occur with minimal stress, for example, a change in body position from horizontal to vertical. In women, one of the common causes of stress urinary incontinence is the displacement of the urethra and bladder neck during tension with the anterior wall of the vagina lowered, as well as in menopause due to estrogen deficiency.

Urinary incontinence from overflow (paradoxical ischuria) - involuntary leakage of urine through the urethra as a result of overflow and passive overdistension of the bladder. There is no independent urination and urine is constantly excreted drop by drop through the urethra outward from the extremely crowded, overstretched, decompensated, atonic bladder, which is due to a significant excess of intravesical pressure over the urethral one. Usually, paradoxical ischuria develops with infravesical obstruction of any origin, but more often with hyperplasia and prostate cancer, urethral stricture. It may be due to neurological pathology, for example: diabetic neuropathy, multiple sclerosis or damage to the sacral spinal cord, denervation of the bladder during traumatic surgery on the pelvic organs.

Causes of occurrence:

Depends on the underlying disease.

Treatment:

For treatment appoint:

Treat the underlying disease.