Violation of urination

Violation of urination is a common symptom of urological diseases. It can indicate the presence of a serious problem in the organs of the genitourinary system.

There are following types of urination disorders.

Forms

[1], [2], [3], [4], [5], [6], [7], [8], [9], [10]

Acute retention of urine

Acute urinary retention is a violation of urination, which is characterized by the absence of urination when urinating for it and with a full bladder. There is severe pain in connection with overgrowth of the bladder in unsuccessful attempts to urinate. The stretched bladder acts as a large, elastic globular tumor in the lower abdomen. When percussion is defined stupidity, which sometimes spreads to the navel and above. Acute retention of urine is observed with a transverse lesion of the spinal cord (the first days of infectious and traumatic injuries), adenoma and prostate cancer, postoperative conditions, the presence of a stone and a tumor of the urethra.

[11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21]

Delayed urination

The delay of urination may be a consequence of:

1. diseases and damages of the central nervous system (multiple sclerosis, head and spinal cord tumors, traumatic injuries of the spinal cord and spine, transverse myelitis, dorsal);
2. effects of drugs - atropine, ganglioblokatorov, narcotic drugs;
3. psychogenic (hysterical) conditions;
4. damage to the genito-urinary organs.

[22], [23], [24], [25], [26], [27], [28], [29], [30]

Imperative urges

Violation of urination, which is characterized by the fact that in the presence of urge the patient can not delay the emptying of the bladder for a long time. Imperative urges are most often observed with partial damage to the lateral columns of the spinal cord (multiple sclerosis), with acute cystitis, adenoma and prostate cancer, tumors of the neck of the bladder.

Enuresis

Enuresis is a violation of urination, which is characterized by a sudden uncontrolled emptying of the bladder. Although often referred to as bed wetting, enuresis is possible in the daytime and at night, so you should distinguish between night and daytime enuresis. This type of incontinence is usually observed in children and the elderly; it is caused by the absence of cortical inhibition of the urethra reflex. Nocturnal enuresis occurs in early childhood, less often in schoolchildren and adolescents. Boys suffer more often than girls.

These children show irritability, touchiness, tearfulness, a very strong night's sleep. With age, enuresis gradually diminishes and passes through puberty. Causes of nocturnal enuresis - most often mental trauma, incorrect parenting in the early years with inadequate inculcation of necessary skills. Night urinary incontinence can be observed in disorders of water metabolism (polydipsia, polyuria), chronic diseases with deterioration of the general condition of the body (infection, rickets, eating disorders, etc.), anomalies in the development of the spine and spinal cord (non-healing of the sacrum and lumbar vertebrae, myelodysplasia), pathological processes in the urinary tract (cystitis, phimosis, narrowing of the urethra), in the presence of adenoid sprouting and intestinal parasites, disturbance of night sleep with excessive sleep presentation.

[31], [32], [33]

Polyuria

Polyuria is a violation of urination, which is characterized by an increase in daily diuresis to 3000 ml or more. Polyuria, resulting from oral intake or intravenous infusion of large amounts of fluid, is benign, temporary. At the same time, a stable polyuria can occur with a variety of nephrogenic, neurogenic and psychogenic disorders.

Causes of polyuria:

1. primary polydipsia (when using a large amount of fluid), a violation of water metabolism;
2. diabetes insipidus - neurogenic and nephrogenic;
3. saline diuresis: additional salt intake, use of large doses of isotonic solutions;
4. osmotic diuresis: diabetic hyperglycemia, long-term infusion of mannitol;
5. natriuretic syndromes (salt depletion, inability to retain sodium) in cystic kidney disease, using diuretics.

Oliguria

Oliguria is a violation of urination, which is characterized by a diuresis with less than 400 ml / day. Oliguria is usually considered taking into account its division into prerenal (due to insufficient renal perfusion), renal (due to diseases of the kidney itself) and postrenal (caused by extrarenal causes, including neurogenic ones).

When the bladder is paresis (multiple sclerosis, tumors of the spinal cord, funicular myelosis, dorsal spin), there are disorders of not discharge, but only emptying.

In the Parkhon syndrome (excessive release of vasopressin), oliguria is also noted.

Pollakuria

Pollakiuria - frequent urination. If pollakiuria is not a consequence of polyuria, it is usually characteristic of diseases of the uropoetic apparatus and of psychogenic dysuria. This violation of urination can be observed in healthy people under the influence of cold, agitation, humidity, alcohol, with psychogenic disorders, inflammatory diseases of the urethra and bladder, the presence of stones in the bladder, diseases of the prostate. The beginning enlargement of the prostate gland primarily causes frequent urination to urinate at night.

Nocturia

Nocturia - a violation of urination, which is characterized by the predominance of nocturnal diuresis over the daytime due to the amount of urine and the frequency of urination. It is observed in the syndromes of vegetative insufficiency, accompanied by denervation of the juxtaglomerular apparatus of the kidneys, with psychogenic disorders, in the early stages of chronic renal insufficiency.

Violation of urination: classification

Currently, the following four classifications of urinary disorders are used in practice.

The classification of N. OK Gibbon (1976) is based on a neurological, topical approach

Violation of urination due to suprasacral lesion.

Violation of urination due to sacral injury:

1. Motor damage.
2. Sensory lesion.
3. Motor and sensory damage.

Mixed defeat.

Violation of urination: I.McLellan classification (1939), modified by J. Lapides (1970)

The following clinical and physiological manifestations are based:

1. Sensory neurogenic bladder.
2. Motor paralytic bladder.
3. Non-inhibited neurogenic bladder.
4. Reflex neurogenic bladder.
5. Autonomic neurogenic bladder.

Violation of urination: the classification of RJKrane, M.strong.Siroky (1979)

The classification uses urodynamic data; it is broader than neurological.

I. Detrusor hyperreflexion (or normoflexia):

1. Coordination of sphincters.
2. Dyssynergia of the striated sphincter.
3. Dissynergy of smooth muscle sphincter.
4. Non-relaxed smooth-muscular sphincter.

II. Detrusor detoxification:

• Coordination of sphincters.
• Non-sagging striated sphincter.
• Denervation of the striated sphincter.
• Non-relaxed smooth-muscular sphincter.

In Ukraine, it is customary to distinguish the following forms of urination disorders

1. Reflex bladder.
2. Hyperreflective urinary bladder.
3. Hyperreflective urinary bladder.
4. Areflex bladder.

Even more schematizing the violation of urination, we can assume that the defeat of the supragmentary parts of the nervous system is characterized by a so-called non-inhibitory bubble (reflex or hyperreflective), and for damages localized within the peripheral reflex arc, autonomous (hyporeflective).