Urinary disorders in men

Chronic urinary retention is the inability to empty the bladder. Symptoms depend on the amount of residual urine and signs of the disease that caused chronic urinary retention.

A large volume of fluid remaining in the bladder is characterized by heaviness in the lower abdomen and a reduction in the time between visits to the toilet. To identify pathology, ultrasound diagnostics of the pelvic organs, urethrocystoscopy and other research methods are used.

In some cases, chronic urinary retention is caused by disorders in the human nervous system. For diagnosis, studies are used to test the functionality of the spinal cord and brain. Along with instrumental methods, the patient is prescribed tests.

Urinary retention (ischuria), in most cases, is diagnosed in male patients. Elderly people are at risk. The occurrence of chronic urinary retention, which develops due to disturbances in the functioning of the nervous system, does not depend on a person’s gender. The pathology is treated by a urologist. If there are disorders in the nervous system, a neurologist is involved in treatment.

General information about the disease

This disease is often a signal that the child has an inflammatory and infectious process in the urinary system. It can manifest itself in different forms: pain, frequent urges, etc. The disease most often affects boys. Source: T.V. Sergeeva, N.N. Kartamysheva, A.G. Timofeeva Practical advice from a nephrologist // Pediatric pharmacology, 2008, vol. 5, no. 2, pp. 103-107

In girls , in addition to infection, dysuria is caused by vaginitis , a nonspecific inflammation. To make a diagnosis, it is important to determine whether the disease manifests itself during urination or after it, when urine comes into contact with the vagina.

The disease can be temporary or chronic, accompanied by exacerbations.

Causes of pathology:

• impaired innervation of the bladder due to other diseases;
• neurological disorders;
• diseases of the urinary system;
• infections;
• diabetes mellitus or diabetes insipidus;
• impaired kidney function, kidney stones.

Symptoms

• urinary retention caused by obstruction of the urinary tract and organs;
• urinary incontinence (especially at night);
• inability to hold urine when you urge;
• rapid, painful urination in small parts. Source: A.N. Tsygin Urinary tract infection in children // Pediatric pharmacology, 2010, vol. 7, no. 6, pp. 39-42

Laboratory research

After the examination, the specialist prescribes laboratory tests. Along with other diagnostic methods, this allows him to more accurately determine the cause of the pathology and take effective measures to eliminate it. The following laboratory tests are prescribed:

• General blood analysis. Necessary to determine the condition of the patient's body. A blood test can reveal the presence of an inflammatory process that occurs as a result of urine accumulation. In the presence of inflammation in the patient's blood, a high level of leukocytes and an increased erythrocyte sedimentation rate are observed.
• General urine analysis. Used to determine dysfunction of the urinary system. With a large volume of fluid in the bladder after emptying, an increased amount of protein and red blood cells is observed in the urine. The number of bacteria can be determined. The fluid leaving the urinary tract is sterile. When collected, a small amount of microorganisms enters it. A level of bacteria that exceeds the norm indicates an infection in the organs of the urinary system.
• Blood chemistry. The doctor pays attention to creatinine and urea levels. Deviation of indicators from the norm may indicate the development of an inflammatory process.

Classification of dysuria

Main groups of pathologies for dysuria

Learn more about the types of incontinence

Types of urinary incontinence in children

Symptoms

Chronic urinary incontinence is characterized by the absence of pain. Symptoms of chronic ischuria are expressed as signs of the underlying disease. Patients note a feeling of incomplete emptying of the bladder from fluid. Urine excretion occurs in small volumes. In some cases, regular urinary retention leads to bladder overflow. This provokes involuntary leakage of fluid from the urethra.

Urine changes color and physical characteristics. The liquid becomes rich in color and acquires an unpleasant odor. In some cases, bloody inclusions appear in the urine.

It is impossible to independently diagnose chronic urinary retention without the presence of education. If the first symptoms occur, you should contact qualified specialists. The doctor will conduct a series of diagnostic measures. Detection of pathology using modern equipment allows us to obtain accurate information about the presence of ischuria and the stage of development of the primary disease. Thanks to this, the specialist can prescribe treatment that is most effective for a particular patient.

Diagnostic methods

A preliminary diagnosis is made based on parental observations or child complaints. Then, to confirm it, the following can be done:

• urine culture to determine bactericidal flora;
• blood and urine tests;
• Ultrasound of the pelvic and abdominal organs;
• in rare cases - radiography;
• cystoscopy;
• daily monitoring of the volume and time of urine output.

In some cases, girls are advised to visit a pediatric gynecologist for an examination and a smear.

Diagnostics

To identify chronic urinary retention, specialists carry out diagnostic measures. Self-diagnosis is impossible. Delaying a visit to the doctor can lead to the development of various kinds of complications.

The doctor interviews and examines the patient. The specialist studies the available medical documentation. During the interview, the doctor pays attention to the amount of time that has passed since the last urination and the presence of pain in the lower abdomen.

During the examination, the doctor palpates the lower abdomen. If there is residual urine in the bladder, a pronounced increase in size of the organ is observed. It is important for the doctor to consider that a small amount of urine output may be associated with impaired renal function. In this case, the liquid simply does not fill the bladder. If this type of pathology is present, palpation of the bladder will become impossible.

Treatment of pathology

Dysuria is cured when the main cause of its occurrence disappears. Enuresis goes away as you get older.

Treatment tactics are determined by a pediatric urologist based on the diagnosis. In most cases, the child’s condition is stabilized by normalizing the drinking regime and using a special diet.

If dysuria is caused by an infection or hypothermia (and these are the most common causes in children), then therapy will not take much time.

The main thing here is to consult a doctor and under no circumstances use traditional methods or other self-medication techniques. The specialist prescribes medications to the child in individual dosages and determines the duration of the course.

If dysuria is a consequence of tumors, then surgical intervention is necessary.

Treatment of the disease

It is necessary to treat the primary pathology that provoked chronic urinary retention. Once the root cause is eliminated, symptoms disappear and urine flow returns to normal.

Surgical intervention

In some cases, with prolonged stagnation of urine, foci of inflammation occur in the pelvic organs. This requires immediate treatment and removal of residual fluid from the bladder. There are two ways to empty your bladder.

Catheterization. A specialized catheter is used to carry out the procedure. It is inserted into the bladder through the urethra. To avoid pathogenic organisms from entering the urinary system through the ascending route, the catheter, the skin at the entrance to the urethra and its mucous membrane are subject to mandatory disinfection.

During the procedure, male patients are in a supine position with their legs extended. Women undergo the procedure lying on their backs with their lower limbs apart and their knees bent.

The doctor disinfects the catheter and the mucous membrane of the urethra. After this, a layer of specialized gel is applied to the instrument and into the urethra to facilitate the procedure. The catheter is inserted into the urethra until urine begins to flow through it. The specialist attaches a urine bag to the catheter, which is used to collect fluid.

To avoid infection and the development of diseases, the catheter is kept in the bladder for as little time as possible. There are several contraindications to the procedure:

• Acute form of prostatitis.
• Significant narrowing of the urethra resulting from neoplasms, prolapse of the pelvic organs or for other reasons.
• Rupture of the urethra.
• Uncontrolled erection not associated with the patient's arousal.

Cystostomy

If catheterization is not possible, then surgery is performed through the anterior abdominal wall. The puncture is performed using a trocar - a specialized medical instrument.

The patient is in a supine position during the procedure. To avoid pain in the patient, the doctor administers an anesthetic drug. Surgery is performed under local anesthesia. The procedure is carried out in the following order:

• The doctor numbs the area of ​​the operation.
• At the site where the instrument is inserted, the specialist makes an incision in the skin. This makes it easier to puncture the tissue with the trocar.
• The surgeon pierces the anterior wall of the abdomen and bladder with a sharp movement.
• When piercing, the doctor must monitor the depth of insertion of the instrument. Insertion that is too deep may result in injury to the opposite wall of the bladder.
• A catheter is inserted into the trocar tube and sewn to the skin. This is necessary in order to eliminate the risk of spontaneous loss.

After the operation, the fluid from the bladder will be completely removed, bypassing the urinary tract. To avoid disruption of the functionality of the muscle membrane of the bladder, it is necessary to carry out certain exercises. They are aimed at training the muscles of the shell.

Drug treatment

If ischuria develops due to psychoemotional stress, the patient is prescribed sedatives. In some cases, conservative treatment is possible by exposure to the sound of flowing water and washing the external genitalia.

Sedatives have a calming effect on the patient's body. The duration of taking sedative medications is selected by the doctor, taking into account the individual characteristics of the patient’s body. Antispasmodic medications can be used to reduce muscle tone. Uncontrolled use of medications can lead to the development of serious complications. If symptoms of pathology appear, you must contact qualified specialists.

SM-Clinic gives children health

“SM-Clinic” is a team of some of the best doctors in St. Petersburg. We employ pediatric urologists, gynecologists, andrologists, and pediatricians. Diagnostics are carried out using advanced equipment, laboratory tests are carried out in a short time.

We find an approach to each patient, act delicately and courteously. If surgical intervention and hospitalization are required, we guarantee a short rehabilitation period in a comfortable room under round-the-clock supervision of medical personnel.

Call us if you notice the slightest urinary problem in your child. Do not delay in seeing a doctor, because all types of dysuria are painful conditions that greatly reduce the quality of life.

Sources:

1. T.V. Sergeeva, N.N. Kartamysheva, A.G. Timofeeva. Practical advice from a nephrologist // Pediatric pharmacology, 2008, vol. 5, no. 2, pp. 103-107.
2. A.N. Tsygin. Urinary tract infection in children // Pediatric pharmacology, 2010, vol. 7, no. 6, pp. 39-42.
3. T.N. Gusarova, U.N. Klochkova, N.V. Mazurova, T.V. Sviridova. Modern view on the problem of bedwetting in children // Issues of modern pediatrics, 2012, vol. 11, no. 3, pp. 116-119.

The information in this article is provided for reference purposes and does not replace advice from a qualified professional. Don't self-medicate! At the first signs of illness, you should consult a doctor.

Gynecological examination

Identification of the causes of chronic urinary retention in female patients can be carried out using a gynecological chair. During the examination, the gynecologist determines the presence of pelvic organ prolapse. Organ prolapse can partially block the normal flow of urine from the patient's body. During the examination, the patient is in a supine position. A gynecological examination can reveal not only prolapse of the pelvic organs, but also the occurrence of malignant or benign formations.

During the diagnostic process, a disease is identified that leads to the development of chronic urinary retention. When treating, it is necessary to first eliminate the root cause of the pathology. Additionally, the patient may be prescribed a computed tomography or other examination methods.

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