Urine retention is a pathological condition characterized by incomplete emptying of the bladder and intermittent urination. Most often it occurs against the background of other inflammatory diseases of the genitourinary organs. Urinary retention is called ischuria. Depending on the form of the disease, treatment can be medical or surgical.
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Types of ischuria
Taking into account the peculiarities of the course of ischuria, there are two types:
- Acute - occurs suddenly due to mechanical blockage of the urethra. It is not possible to empty the bladder, but the patient experiences a strong urge to go to the toilet.
- Chronic - develops gradually and has no pronounced clinical signs. Pathology is dangerous because the patient does not see a doctor for a long time, which increases the likelihood of complications.
Prolonged acute urinary retention (ICD-10 - R33) provokes the multiplication of bacteria and their spread to other urinary organs. Pathogenic microorganisms can cause cystitis, orchitis, pyelonephritis. Also, the danger of ischuria is the rupture of the filled bladder and the development of peritonitis. Acute urinary retention requires emergency medical attention, as dangerous complications can occur.
Chronic urinary retention provokes prolonged stagnation of urine and increased pressure in the bladder. Against the background of this process, vesicoureteral reflux is formed, in which urine flows from the bladder back into the ureter. The pathological process disrupts the physiological dynamics of the upper urinary tract, which provokes hydronephrosis.
Congested urine is at the optimum temperature for bacteria to grow and is a valuable breeding ground for them. In 95% of patients with chronic ischuria, secondary cystitis is detected.
Concentrated secondary urine contains a large amount of calcium salts, which, in combination with protein, bacteria and leukocytes, causes urolithiasis. In addition, the chronic form of ischuria threatens with inflammation of the kidneys and the development of renal failure.
No urge to urinate: causes of pathology
Delayed urination can occur due to the following reasons:
- diseases of the central nervous system;
- Urolithiasis;
- excessive consumption of strong alcoholic beverages;
- strong stress;
- drug use;
- diseases of the rectum;
- pelvic organ prolapse;
- brain and spinal cord injuries;
- benign and malignant neoplasms in the urinary organs;
- long-term use of antibiotics, antihistamines, antidepressants.
Urine retention in men appears with adenoma, prostatitis and prostate cancer. There is also no urine for neurological disorders, such as multiple sclerosis, after a stroke.
Acute urinary retention in women can occur after childbirth, with hypothermia of the genitourinary system, diabetes mellitus, genital herpes. Often, uterine fibroids lead to the pathological process, which, as it grows, compresses the bladder or urethra.
Symptoms of ischuria
In acute urinary retention, the patient is concerned about the following symptoms:
- pain syndrome in the lumbar region;
- excessive sweating;
- painful sensations in the lower abdomen, a feeling of fullness;
- chills;
- nausea, vomiting;
- strong urge to urinate;
- lack of urine output;
- body temperature over 38 degrees;
- tachycardia;
- arterial hypertension.
Sometimes the stream during urination is abruptly interrupted. The patient is concerned about the feeling of incomplete emptying of the bladder.
Chronic urinary retention in men and women is accompanied by the following symptoms:
- frequent urination at night;
- decreased urine output;
- pain in the pubic area, a feeling of heaviness;
- weak or intermittent urine stream;
- Spontaneous leakage of urine.
In most cases, ischuria develops as a secondary disease, so the patient may complain of other symptoms of urological disorders, which led to urinary retention. A thorough examination is required to determine the cause of the pathological condition.
Disease diagnosis
To find out the causes of ischuria and make a diagnosis, the urologist first evaluates the patient's complaints. With the help of percussion and palpation, the doctor detects an enlarged bladder. A number of studies will help establish an accurate diagnosis:
- general blood and urine tests;
- bakposev urogenital secretions;
- Ultrasound of the pelvic organs;
- electromyography;
- Ultrasound of the uterus and appendages in women;
- analysis of the level of prostate-specific antigen in the blood;
- rectal examination of the prostate;
- Ultrasound of the prostate gland in men.
Women may additionally need to consult a gynecologist. The urologist also carefully examines the patient's medical history. In order to make a correct diagnosis, the doctor must know about all chronic diseases, past injuries, inflammatory and infectious processes, and previous diagnostic and therapeutic procedures.
