Urination disorder

Introduction Difficulties in urination are caused by poor urination and urinating. The degree of dysuria is related to the condition of the disease. In the case of light, the urinary tract is delayed and the range is short. In severe cases, the urinary line becomes thinner, the urine flow is dripping and not in the line. When urinating, even the force of holding the breath is required, and even the lower abdomen needs to be pressed by hand to discharge the urine. Severe dysuria can develop into urinary retention. In the early stage, it may be dominated by mechanical causes, and in the advanced stage, dynamic disorders may occur. For example, in benign prostatic hyperplasia, dysuria may be caused by obstruction of proliferating prostate in the early stage. If it is not treated in time, it may lead to bladder detrusor injury and cause dysuria.

Cause

(1) bladder neck lesions

The bladder neck is blocked by stones, tumors, blood clots, foreign bodies; or uterine fibroids, ovarian cysts, late pregnancy compression; due to bladder neck inflammation, stenosis.

(2) posterior urethral disease

Due to prostatic hypertrophy, prostate cancer, acute inflammation of the prostate, hemorrhage, empyema, fibrosis after compression of the urethra; inflammation of the posterior urethra itself, edema, stones, tumors, foreign bodies, etc.

(3) anterior urethral disease

Found in the anterior urethral stricture, stones, tumors, foreign bodies, or congenital malformations such as urethral valgus, penile foreskin incarceration, abnormal penile erection.

an examination

Related inspection

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1. History of dysuria

Ask about the history of colic in the lower abdomen and perineal area to understand the presence or absence of stones.

Asked about the speed and course of dysuria, the prostatic disease is slow and the course is long, while the posterior urethra hemorrhage and abscess are fast and the course is short.

Understand menstruation and pregnancy to determine gynecological and obstetric conditions that cause dysuria.

Ask about the history of diabetes, history of spinal trauma; ask about the history of neuropsychiatric diseases.

2. Examination of dysuria

The anal digital examination determines the size, texture, surface smoothness, tenderness, and tumor of the prostate.

3. Laboratory tests for dysuria

Regular examination of prostatic fluid is important for the diagnosis of prostatitis.

4. Device examination for dysuria

Cystoscopy is helpful for the diagnosis of bladder neck stenosis, stones and tumors.

X-ray examination is helpful for the discovery of recessive spina bifida and spinal trauma.

Ultrasound is helpful in diagnosing prostate disease and can also determine urinary retention in the bladder.

Differential diagnosis

1. Bladder neck stones: Before the dysuria occurs, there is colic in the lower abdomen, and the pain radiates toward the perineal perineum. The painful hematuria or microscopic hematuria occurs at the time of pain or pain.

2. Blood clots in the bladder: often secondary to blood diseases such as hemophilia, leukemia, aplastic anemia, etc.

3. Bladder tumor: dysuria gradually worsens, the course of disease is long, and distant metastatic tumor lesions can be found in the late stage.

4. Prostate hypertrophy, prostate cancer, prostatitis

5. Posterior urethral injury: There is a history of trauma in the perineal area, difficulty in urinating after trauma or no urine discharge.

6. Anterior urethral stricture: seen in the anterior urethra scar, stones, foreign bodies and so on.

7. Spinal cord damage: Patients with paraplegia caused by various causes, in addition to dysuria, there are still sports and sensory disturbances.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.