Dysuria

Description:

Difficulty or increase of an urination.

Dysuria symptoms:

Frustration of an urination (dysuria) are characteristic, as a rule, of diseases of the lower uric ways (a bladder, a prostate gland, an urethra) and happen two main types - speeded up and complicated, the last quite often is followed by an urination delay.

The speeded-up urination (pollakiuria) can be a state physiological or be a consequence of not urological and urological diseases.

At an average diuresis of 1500 ml and normal capacity of a bladder of 250-300 ml at healthy faces the urination occurs 4-5 times in the afternoon and 1 time at night. Its increase at plentiful drink, cooling or nervousness is considered as the phenomenon physiological.

At sugar or not diabetes mellitus the speeded-up urination is followed by the normal or increased volume of the emitted urine.

The urodynia which is speeded up repeatedly within an hour, small portions, different intensity, not time-dependent days, takes place at acute cystitis. However at some diseases the pollakiuria changes the rhythm. So, at patients with a prostate hyperplasia the urination is speeded up mainly at night (a night pollakiuria) that is caused by irritation of a sphincter in connection with rush of blood to pelvic bodies during sleep and increase in volume of gland. At a bladder stone, on the contrary, the night urination is not speeded up, and in the afternoon when the patient moves and a stone, moving, irritates nerve terminations mucous, it is speeded up. The pollakiuria is observed often at women at omission of a front wall of a vagina, a bend or a tumor of a uterus and is connected with a circulatory disturbance in a bladder neck.

Difficulty of an urination (strangury) usually arises in the presence of an obstacle to urine outflow - a hyperplasia and a prostate cancer, a stricture, a stone or a tumor of an urethra, narrowing of a prepuce (phymosis), a bladder neck tumor. However it can arise also at its absence at diseases or injuries of a head or spinal cord. Depending on the nature of defeat the urine stream becomes thinner, its intensity decreases, the act of an urination is extended. The patient should make an effort, straining prelum abdominale muscles, began to expect an urination. At the same time the urine stream thin, sluggish, quite often does not describe an arch, falls aweigh down. In far come disease cases urine is emitted on drops.

For overcoming difficulty at an urination there is a hypertrophy of a muscle of a bladder (detruzor) in the beginning, reductions of muscles of a prelum abdominale, a crotch amplify. The urination becomes multievent - the patient releases a part of urine, then after a while again natuzhivatsya and removes the next portion etc. By means of these actions at first it completely empties a bladder (the compensated bladder). However at a certain stage of a disease it cannot make it (a dekompensirovanny bladder) - there is a residual urine which quantity gradually increases and can reach 1,5 l and more, i.e. there comes the chronic delay of an urination (ischuria).

Unlike the chronic ischuria developing gradually the acute delay of an urination arises suddenly and is expressed in impossibility of bladder emptying, despite its sharp overflow. It the hyperplasia and a prostate cancer, a stone of a back urethra, acute prostatitis, an injury are the most frequent reasons, is much more rare - an operative measure on bodies of a small pelvis, an emotional factor etc. It is promoted by rushes of blood to a giperplazirovanny prostate at a lock or a diarrhea, an exacerbation of hemorrhoids, a recystectasia at intoxication.

At women the chronic delay of an urination at a tumor of generative organs is more often observed or urethras and it is connected with an urethra prelum.

At children the acute or chronic delay of an urination happens at a phymosis and acute cystitis when the child abstains from an urination because of morbidity.

It is necessary to differentiate an ischuria from an anury in connection with the symptom, general for these concepts, - lack of an independent urination. It is necessary to remember that at an ischuria the bladder is crowded, there are desires to an urination, but the patient cannot urinate; at an anury the bladder is empty, desires to an urination are absent.

Urine incontience - a state at which there is an involuntary expiration of urine on an urethra (a true incontience) or girlfriends to channels (a false incontience) and it can be established visually. Dysfunctions of a detruzor and a sphincter of an urethra, and also a recystectasia, false - the given rise defects of an ureter, a bladder and urethra, urinogenital or mochekishechny fistulas are the main reasons for emergence of a true incontience.

Distinguish several main types of a true incontience of urine - imperative, stressful, from overflow, night.

Imperative (urgentny) incontience - release of urine in different quantities on an urethra at height of an uncontrollable imperative (imperative) desire on an urination. These patients at this moment have a feeling that the urination just about will begin and any delay can end with urine not deduction. It can be observed at a bladder inflammation, especially necks, a back urethra and a prostate, and also a hyperplasia of the last. The detruzor hyperactivity is the most frequent reason of an imperative incontience of urine.

Stressful (at a tension) an incontience - involuntary release of urine on an urethra at cough, sneezing, a weight raising etc. It is caused by increase in intra belly and intravesical pressure at patients with insufficiency (weakness) of an urethral sphincter and muscles of a pelvic bottom. It is observed at an injury and a tumor of a spinal cord, a myelitis, after rectum operations, a hysterectomy, transurethral endoscopic manipulations, etc. At men the most often stressful incontience of urine is observed after an adenomectomy or a prostatectomy that it is connected with damage of a sphincter of an urethra. It can be constant or arise at the minimum tension, for example, to a body postural change from horizontal in vertical. At women of one of the frequent reasons of a stressful incontience of urine the shift of an urethra and neck of a bladder is during tension at the lowered front wall of a vagina, and also in a climacteric in connection with the arisen oestrogenic deficit.

Urine incontience from overflow (inconscience with overflow) - the involuntary expiration of urine on an urethra as a result of overflow and a passive recystectasia. The independent urination is absent and urine constantly on drops is emitted on an urethra outside from extremely crowded, hyperinflate, dekompensirovanny, atonichny bladder that is caused by considerable excess of intravesical pressure over urethral. Usually the inconscience with overflow develops at infravezikalny obstruction of any genesis, however a thicket at a hyperplasia and a prostate cancer, an urethra stricture. It can be caused by neurologic pathology, for example: diabetic neuropathy, multiple sclerosis or damage of sacral department of a spinal cord, bladder denervation at traumatic operation on bodies of a small pelvis.

Dysuria reasons:

Depends on a basic disease.

Treatment of the Dysuria:

Carry out treatment of a basic disease.