Urinary retention in men what to do. What to do with acute urinary retention? Diagnostics in a hospital setting

The difficulty of such a habitual process as urination signals disorders in the body. In men, it is observed more often due to the structural features of the urethra. If there is an urge, but it doesn’t work out normally to go to the toilet “in a small way”, urine must be “squeezed out” with difficulty from oneself - urgently to the hospital!

Urinary retention (ischuria) is a condition when a patient, for reasons beyond his control, cannot empty the bladder, although it is filled with urine. Pathology is associated with both physiological and psychological grounds. Urinary dysfunction occurs at any age.

But most of those who make such a complaint are older men. The fact is that after 60, many have an enlarged prostate gland with the development of adenoma or prostatitis.

In general, the delay occurs under the following circumstances:

Pathologies of the urinary and reproductive systems, and other organs of the small pelvis lead to the latter situation. If a problem is found, you need to contact a urologist for examinations.

Why does urinary retention occur in men

According to various sources, from 1 to 7% of patients with ischuria are suffering from prostate adenoma. The overgrown formation bends the urethra and urine passes through it with difficulty.

Also, blockage of the urethra and squeezing of the bladder occur in such cases:

• with congenital patency disorder;
• urethral stricture;
• diverticulum (protrusion of the bladder wall);
• stones;
• the formation of polyps;
• in the presence of a malignant formation in the urethra or urea;
• prostatitis;
• inflammation and injury to the penis.

The bladder is also squeezed in violations, at first glance, not related to urination. For example, with a hematoma or inguinal hernia.

Problems with urine excretion are often observed after surgery, in the abdominal organs or spine, when the patient is forced to remain in bed in a horizontal position for a long time.

If found, in men, the reasons may be as follows:

• addiction to alcohol or drugs;
• CNS disorders;
• freezing;
• physical and nervous strain;
• bleeding in the bladder;
• use of sleeping pills or antidepressants.

Taking certain drugs is a medical cause of ischuria.

In addition to antidepressants, such drugs include non-steroidal anti-inflammatory drugs, antihistamines, and hormones.

Urinary problems are related to the functioning of the brain and central nervous system.

Therefore, such violations sometimes lead to failure:

• brain pathology;
• injuries affecting the spinal cord;
• cerebrovascular disease;
• polio;
• multiple sclerosis;
• diabetes.

Often, problems with urination begin after, due to some circumstances, a person deliberately restrained himself from going to the toilet. Therefore, when urging, doctors strongly recommend not to endure.

Classification of violations

Depending on how difficult urination is, the following types of delay can be distinguished:

1. Complete. Even with obvious urges to go to the toilet does not work. A special tube is used to remove fluid from the bladder.
2. Incomplete. Urine flows out with difficulty, you have to strain your muscles. A tiny volume or intermittent jet is released.
3. Paradoxical. Urinary is strongly filled, but is not emptied. Discharge from the urethra appears on its own.

Incomplete delay often worries for a long time, but the patient does not attach importance to it, aggravating his condition.

Depending on the course of the disease, ischuria is of two varieties:

1. Acute. It makes itself felt suddenly, accompanied by pain in the lower abdomen, constant urge to go to the toilet.
2. Chronic. It develops asymptomatically, gradually starting to disturb a person. Often the exit of urine is impossible without a catheter installed in the urinary canal.

Chronic incomplete ischuria has been bothering some patients for years, and in other cases it progresses imperceptibly for a man.

A severe form of ischuria, one of the serious complications, is called paradoxical. Due to the strong stretching of the urea and its sphincters, the patient begins a kind of incontinence - urine is arbitrarily released from the canal in drops.

Associated symptoms in men

Against the background of complications with urination, patients have:

• stomach ache;
• heat;
• flatulence of the intestine;
• strong gases;
• headache;
• nausea;
• urination with discomfort at the beginning of the process.

The patient complains of weakness, feeling of fullness in the groin. When probing, the perineum responds with pain.

This is due to the fact that not being able to completely empty, the bladder puts pressure on the walls of the groin.

Consequences of the syndrome

In addition to the development of dangerous forms of the pathology itself, it also leads to other negative consequences:

The main "blow" at falls on the kidneys and the urea itself.

But patients can also begin urogenic sepsis - spreading the infection through the bloodstream.

Diagnostics

To determine why a patient cannot urinate, a number of tests are performed at the hospital.

Only on the basis of the results of examinations, the doctor is able to prescribe the correct treatment.

Urgent help at home

You can find many different tips for providing emergency care in a similar situation, but it is important to remember: the doctor should perform the treatment.

If a man suddenly finds himself unable to urinate, and there is no pain, the cause may be hiding in stress. Then you should give him cool water to drink, calm him down.

With severe pain, it is better to immediately call an ambulance.

Complex treatment

With acute stasis of urine and the development of complications, the treatment of urinary retention implies the need to urgently catheterize the bladder to release fluid.

But if you carry out the procedure once, up to 70% of those suffering during the week turn to the urologist with repeated complaints.

In order for the treatment to ultimately bring relief, patients are prescribed appropriate therapy. Basically, doctors prescribe alpha-blockers. With the help of these drugs, prostate adenoma is also treated.

Patients with a chronic form are advised to periodically self-connect a catheter. Thanks to this procedure, complications such as urosepsis and kidney dysfunction can be avoided. How, if necessary, to carry out self-catheterization, the urologist will explain.

The disadvantage of introducing a tube is the potential for microtrauma of the mucous membranes of the urethra, which lead to the development of sepsis. Sometimes the catheter introduces an infection.

It is also forbidden to use it if the patient has already damaged the urethra or he suffers from prostatitis.

In such cases, a puncture is prescribed to release the accumulated fluid. They carry it out like this. The patient is under anesthesia. At a height of 1.5 cm above the pubis, at right angles to the man's urea, about a fifteen-centimeter needle is inserted to a depth of 5 cm.

If the removal of fluid from the urea and therapeutic treatment does not lead to a positive result, there is a need for a surgical operation.

When the cause of the problem is identified, a consultation of specialists is appointed, who will determine how to properly treat it.

Traditional medicine in the process of getting rid of the disease can only be used as an aid and after consultation with the attending physician.

In some cases, for example, it is useful to take tea rose or rosehip tinctures.

Prevention

Prevention of the disease consists in the increased efforts of the patient himself to prevent pathologies that provoke the development of the problem.

To avoid the unpleasant state of ischuria, it is recommended:

1. Drink as little alcohol as possible.
2. Avoid hypothermia.
3. From the age of 40, regularly examined by a urologist, undergo consultations with an oncologist.
4. To be protected from injuries of the lower abdomen and the ingress of foreign bodies into the urethra.
5. Always treat any inflammation in the body, especially pathologies related to the genitourinary system.

Before you start a course of medications, it is advisable to consult with doctors about side effects.

In this case, problems with urination can be avoided, or at least it will become known what could have caused the disease.

You may also be interested

Rosehip as an effective treatment for cystitis

One of the troubles associated with the process of urination is urinary retention. This problem, also called ischuria, affects women and children, but most often it occurs in men. Persons suffering from ischuria do not have the opportunity to completely empty the bladder, or they excrete urine intermittently and with difficulty. Symptoms such as enlargement of the abdomen, discomfort in the bladder area, frequent daytime and nighttime urge to urinate or their absence at the right time are the main signs that a person has a problem with urinary retention. What are the causes of this trouble, what kind of danger does it pose for the stronger sex, and how is urinary retention diagnosed and treated in men?

About the varieties of ischuria

There are several types of urinary retention, each of them proceeds differently. Ischuria is chronic and acute, as well as complete and incomplete. When urinary retention begins in a person unexpectedly, accompanied by painful sensations in the abdomen or bladder, overflow of the latter and frequent urge to urinate, then this is an acute complete form of the disease. And with an acute incomplete variety of urinary retention, urine can occur in men in small quantities.

Chronic ischuria is able to be asymptomatic for some time, and as it develops, it becomes more noticeable and reminds of itself more and more. With chronic complete urinary retention, a person is not able to independently perform the process of urination, only a catheter installed in the urethra can help him in this.

In this way, the patient can empty the bladder for more than one year. With an incomplete form of chronic ischuria, a man manages to urinate himself, but his bladder is still not completely emptied and part of the urine remains in it.

There is another form of urinary retention called paradoxical ischuria. With this disease, a person's bladder is greatly stretched, and he cannot voluntarily urinate, but urine is involuntarily released in the form of droplets from the urethral canal. The most severe and painful form for a man is acute ischuria; he may not even be aware of the existence of chronic urinary retention.

Pathological factors for the occurrence of urinary retention

There are a variety of reasons for urinary retention. So, chronic urinary retention can cause the following pathological factors:

1. Various traumatic injuries of the urethra or bladder.
2. Blockage of the urinary organs. The lumen of the canal may be clogged due to the ingress of a stone or other foreign body into it. The blockage occurs either in the vesicourethral segment or in the urethra itself. In the first case, it may be a congenital patency disorder of this segment, a malignant tumor of the bladder or a polyp. In the second case, the blockage is formed due to a diverticulum (protrusion of one of the walls of the bladder) or urethral stricture (narrowing of the lumen in the urethra).
3. Compression of the bladder. It can be caused by pathologies of the urinary and genital organs. These include prostatitis (inflammation of the prostate gland), phimosis, balanoposthitis (inflammation of the head of the penis or foreskin), cancer,. The urinary bladder is also compressed in case of pathologies of organs located in the small pelvis (perineal hematoma, rectal cancer, hernia in the groin, aneurysms of the hypogastric arteries).

Urinary retention, which is chronic, is formed in diseases of the central nervous system, for example, neurogenic bladder dysfunction.

Causes of acute ischuria

In addition to neurogenic dysfunction and pathologies of the genitourinary system and small pelvis, there are other factors that cause problems with urination in men.

Acute ischuria may occur if the following events have occurred:

• trauma to the brain or spinal cord;
• multiple sclerosis;
• operations on the spine or on the abdominal organs, requiring patients to stay in bed for a long time;
• poisoning with drugs or sleeping pills;
• severe alcohol intoxication;
• stress and physical tension;
• hypothermia of the body;
• filling the bladder with blood clots;
• forced delay in the process of urination.

Acute urinary retention, as mentioned above, occurs in men suddenly. But the most common cause of its occurrence is a complication of a disease such as prostate adenoma. When this benign tumor begins to grow, the segment of the urethra that passes through the prostate usually changes: it becomes crooked, stretched in length. All these changes in the urethra affect the outflow of urine, making it difficult and delaying it. With prostate adenoma, the gland itself swells, an increase in its size also leads to urinary retention in men.

Diagnostic measures and methods of treatment of ischuria

Symptoms characteristic of acute urinary retention and the late course of chronic ischuria should not be ignored. Every man who cares about his health should, having the above symptoms, be sure to consult a doctor. A qualified specialist will not only make the correct diagnosis, but also identify the causes of urinary retention, and also prescribe a quality treatment for the disease.

According to the symptoms described by the patient, it will be quite easy for the doctor to understand that we are talking about ischuria, but before treating it, additional diagnostics can be carried out. During a physical examination of the bladder, the doctor can palpate the area above the pubis and thus detect an increase in the size of the bladder. Another diagnostic method is an abdominal ultrasound, which must be done after the patient has urinated. You can measure the volume of urine left in the bladder after the process of urination. If more than 200 ml of urine remains there, we are talking about its delay.

One of the most common methods of treating acute ischuria is catheterization. Its essence lies in the fact that a metal urethral catheter is inserted through the urethra into the bladder, it helps the urine to come out of the bladder to the outside. Catheters are also made of rubber. So, the Timan device has a beak-shaped bend at the end, which allows the catheter to better pass through the urethra to the bladder. Rubber catheters, unlike metal ones, can stay in a man's body from a day to 1-2 weeks. Then there is an improvement, and the person can urinate fully in the future, urinary retention disappears. To make the treatment more effective, along with catheterization, patients are prescribed alpha-blockers, which are also used in the treatment of prostate adenoma.

The disadvantage of urethral catheterization is the possibility of causing microtrauma to the mucous membranes of the urethra. The latter can lead to the development of urosepsis. Some catheters can introduce infections into the urinary tract, and a man may develop urethritis. It is forbidden to use urethral catheters in cases where a person has damage to the urethra or suffers from prostatitis.

How, in this case, to treat ischuria? There is such a method of removing urine from the bladder as a capillary puncture. The method consists in the fact that a long needle (about 15 cm) to a depth of 5 cm is inserted into the patient in a supine position, under anesthesia, 1.5 cm above the pubis and at a right angle to it. A soft tube is put on the outer end of the needle.

The needle should enter the bladder and help the urine flow out of the bladder through the tube. When the organ is emptied of urine, which happens very quickly, the needle is removed and the injection site is lubricated with iodopyrine. This procedure can be performed several times a day. It is especially effective for prostate adenoma.

Difficulty in spontaneous urination in men can be treated with bladder drainage. So, after anesthesia, patients are cut through the skin along the line of the middle of the abdomen above the pubic joint and carefully insert the trocar inside. When this instrument reaches the bladder and the stylet makes a puncture, a rubber catheter is inserted through the hollow tube of the trocar, and urine flows out of the bladder through it. This operation is quite simple and safe, since the prostate is not damaged by the trocar and urinary streaks do not occur.

Frequent drainage of the bladder causes it to shrink, the elasticity of the walls decreases, so people with urinary retention should always flush the bladder with antiseptic solutions, periodically fill it with fluids and keep them inside for a while. Competent doctors will take a responsible approach to the treatment of ischuria and, choosing the most appropriate method, will help patients get rid of problems with urination.

If the process of emptying the bladder is impossible, a feeling is constantly present. When the process does not occur, this indicates the presence of some kind of pathology. For example, trauma to the brain (spinal). Anuria and, these are different pathologies. With anuria, urine does not enter the urea at all.

Causes of urinary retention

Delays in the outflow of urine with pain symptoms and incomplete emptying occur when:

full bladder

• urolithiasis;
• narrowed area of ​​the foreskin of the organ;
• hematomas or aneurysms in the pelvic area;
• infectious pathologies;
• inflammatory processes of the prostate gland, the head of the organ;
• injury to the urethral canal or urea.

Additional symptoms may include:

• bleeding with the discharge of blood clots;
• tumor formations of the urea, prostate and other organs in the small pelvis;
• congenital pathological structure of the urinary system, which becomes an obstacle to the normal outflow of urine;
• benign formation (adenoma).

When a man complains to the doctor - I can’t write what to do - in men, a pathological phenomenon may occur accompanied by another disease:

• multiple sclerosis;
• damage to the brain or spinal cord;
• severe intoxication with alcohol, drugs, sleeping pills;
• hypothermia;
• frequent stressful situations;
• impossibility of timely emptying of the urea;

Sometimes urination is disturbed due to other reasons:

• prostatitis;
• urolithiasis of the urethral canal, urea;
• adenoma;
• phimosis;
• neoplasms;
• prostate cancer;
• CNS pathology.

An acute absence of the process of urination can occur in a state of severe intoxication, after suffering severe stress, hysteria, surgery on the rectum, perineum, after prolonged bedridden, drug poisoning.

Explaining the causes of urinary retention

Frequent interruptions or acute retention of urine marked prostate adenoma in a strong half of the population over the age of sixty years.

A sedentary lifestyle, frequent diarrhea or constipation are characteristic of adenoma. In this case, urine can not depart in full. Sometimes there are traces of blood in the urine, the patient feels an increase in temperature. With fractures of the bones in the hip, trauma to the urethra, there may also be retention of urine.

Acute delays have a peculiar course.

1. Initially, urine flows well, then it stops. At the same time, the urea is not completely emptied. When patients cannot completely empty their bowels, this warns of stone formations in the urethral tubule or urinary ducts. When a man changes body position, he can urinate (establishing an outflow).
2. With constant delays in urine, the walls of the bladder, the sphincter get gradually stretched. During such a pathological process, incontinence is possible, urine can be rejected by drip or in small portions.
3. When there are pains in the inguinal zone, cramps during the outflow of urine and the desire to visit the toilet. In this case, catheterization is performed with further examination to detect the initial factors that led to the pathological phenomenon.

Carrying out diagnostic manipulations

In order to make a diagnosis of the pathological process, one should not forget that difficulties with urine output are not a separate pathology, but a complication of an acquired or congenital disease. This suggests that the identification of an unmistakable cause of the pathological process is responsible for the effective treatment of this manifestation.

To identify the factors that led to such discomfort, a competent diagnosis is carried out. With difficult processes of outflow of urine, a painful syndrome is noted, but such a sensation also occurs with other pathological changes.

The specialist reveals a painful characteristic in order to continue the differential diagnosis.

Diagnosis is carried out with confirmation of the results of plasma and urine tests.

The specialist may prescribe an ultrasound examination to determine the size, thickness, presence of foreign objects in the urea.

Methods of medical manipulations

To prescribe the treatment of unpleasant phenomena in the form of urinary retention, it is required to identify the underlying disease that provoked this process.

Urologists prescribe anti-inflammatory drugs, antibacterial agents. To prevent acute pathology, catheterization is used (this is a one-time assistance, for further medical therapy). Often, patients use alternative treatment using traditional medicine.

With a disturbed outflow of urine for a mechanical reason, sometimes a decision is made for surgical treatment. If the disease is infectious, antibiotic therapy with sulfonamides is prescribed.

In some cases, a special implant is sewn to the wall of the urethra, which helps to stimulate the normal spasm of muscle tissue in the urination canal. This method allows you to establish emptying processes, making them regular.

Folk recipes

Traditional medicines do not have such effectiveness for eliminating the underlying disease. Doctors recommend their use to relieve painful symptoms as an additional measure in the overall treatment regimen.

Treatment of the genital and urinary areas should be carried out under the supervision of a specialist.

If urinary retention occurs in men, the causes and treatment should be sought together with the doctor. Due to the disease, the outflow of urine is difficult for a man, which leads to painful sensations and constant discomfort. Self-medication in this state is very dangerous for health, and delaying a visit to a specialist threatens the development of complications and long-term treatment in the future. The lack of competent treatment in the acute period creates favorable conditions for the transformation of the disease into a chronic form. In this case, obstruction of the ureter will become a constant companion of a man.

Not always with problems with the natural outflow of urine, the reason is the work of the kidneys. It is necessary that the doctor carefully examines the patient and analyzes all the symptoms present. Often, a violation of the urination process is an exacerbation of another underlying disease. When filled with urine increases pressure on the lower abdomen and groin walls, a man may experience an increase in body temperature, severe headaches, nausea, and vomiting. Weakness is felt throughout the body, and when the inguinal region is felt, the patient experiences pain. If first aid is not provided to a person on an emergency basis, his condition will lead to the development of such dangerous complications as peritonitis, renal colic, urogenic sepsis and rupture of the urea, due to which urine enters the abdominal cavity.

Obstruction of the outflow of urine can lead to serious diseases

There are the following main causes of violations of the process of urination.

Urolithiasis disease

When the stones move, blockage of the urinary tract occurs.

phimosis

A disease in which there is a narrowing of the foreskin, which prevents the exit of the head beyond the coronal sulcus.

Hematomas and aneurysms in the pelvis

Develop as a result of injuries received by a man.

Infectious diseases

The infection provokes swelling, irritation and inflammation of the tissues. The inflammatory process gradually passes to the urethra, causing swelling of the urea sphincter.

Urinary tract infections

If there are inflammatory processes in the prostate, this can cause an increase in the organ to the sides and inside the urethra, which gradually narrows. For the process of urination to occur, the muscles of the bladder have to contract with great effort.

However, the muscles cannot endure such tension for too long, so they soon become incapable of normal contraction.

Injuries to the urethra and bladder

An injury can be received by a man as a result of surgery or during a blow, penetrating injury.

Injury sustained while playing sports

Drug treatment

A side effect of some completely harmless drugs is urinary retention. If the patient has noticed such a negative effect on his body, you should contact a specialist to find another suitable drug. Urinary retention can occur due to long-term use of allergy-fighting antihistamines, antidepressants, and anxiety medications.

Other causes of difficult urine outflow are some mechanical disorders, obstruction of the genital tract, or functional disorders at the level of nerve fibers. If there are problems with the functioning of the nervous system, then the sphincter muscles may not respond to the commands of the body, be too tense and relaxed. Failure of the nervous system leads to the absence of the urge to urinate, as well as improper functioning of the muscle fibers of the bladder.

The problem may occur as a side effect of medication.

In men, the acute form of urinary retention sometimes manifests itself in a peculiar way. At first, urine leaves the body naturally, but suddenly the process is interrupted and the urea remains incompletely emptied. When the position of the man changes, urination will continue. This phenomenon has clear signs of the presence of stones in the bladder that block the opening of the urethra or urinary canal. If urinary retention becomes a habitual phenomenon, the muscular walls of the bladder and sphincter are stretched, which is why an uncontrolled release of a few drops of urine is sometimes observed.

If a man notices the appearance of alarming symptoms associated with interrupted urination or no urination at all, it is necessary to immediately call emergency care. Before the doctors arrive, it is not recommended to take any action. Doctors themselves sometimes recommend taking a warm bath, but never a hot one. Relaxation of the smooth muscles of the urinary tract will help to briefly restore the flow of urine and ease the discomfort felt by the patient. For this, it is allowed to take No-shpu or put candles with papaverine. Some patients benefit from a cleansing enema, but it should not be administered alone in an acute condition.

If the patient's condition is not acute and the man himself came to see a specialist, the doctor will need to examine the patient and a thorough examination to make a diagnosis. Only after that drugs and methods for treatment are selected. Diagnosis of the entire genitourinary system includes the following activities:

• Analysis of urine. In the absence of urination, urine is taken from the bladder using a catheter;
• swab from the urethra. The study is intended to identify pathogenic microflora, as well as pathogens;
• blood analysis. Helps identify infections in the urethra;
• ultrasound. Ultrasound examination of the urea and ureter will help determine the weakened muscles;
• CT and MRI. Examination of the patient with the help of various tomographs is prescribed in the presence of nervous disorders of the spine or brain.

The patient needs to pass a urine and blood test, a smear and undergo other diagnostic tests.

Knowing what to do if a man does not have urine and how to help him in such a situation, you can avoid the development of complications, as well as the deterioration of the patient's well-being. Even if taking No-shpa or a warm bath will help improve a person's condition, you should not postpone a visit to the doctor. The measures taken give only a temporary effect of relief, while the true cause of the violation of the outflow of urine remains.

To improve the patient's well-being and eliminate acute urinary retention, a catheter is inserted, with the help of which urine is removed from the bladder. Such manipulation will give an effect for some time, but it cannot be considered a treatment.

When the natural outflow of urine is not possible due to mechanical disorders, surgical intervention is required. If there is an inflammatory process caused by an infection, then antibiotics and sulfonamides are prescribed. Modern methods of treatment also include the insertion of an implant. It is attached to the wall of the bladder and serves as a special stimulator for the contraction of muscle tissue in the urethra. Thanks to this stimulation, it is possible to establish the process of urination and make urination again regular and complete.

Sometimes it is necessary to use emergency measures to eliminate urinary stagnation

Among the emergency measures to eliminate the stagnation of urine in the bladder, there is also cystomy of the bladder. It is performed in cases where it is impossible to eliminate acute urinary retention using a conventional urethral catheter. Cystomy involves a puncture of the bladder and the introduction of a special tube through the walls of the abdomen near the suprapubic region. The removal of fluid from the bladder is carried out just through the introduced tube. As soon as doctors manage to eliminate the danger and alleviate the acute condition of the patient, it is necessary to develop a further treatment plan.

Treatment of urinary retention with folk methods

Treatment of urinary retention in men with the help of folk recipes shows excellent results. The following infusions help to cope with temporary muscle spasms:

• tea rose fruit. An enameled or glass container is filled ½ with fruits and poured with boiling water. Leave the infusion for several days so that it acquires a yellowish tint, after which it is taken according to the following scheme: 10 drops of the infusion are mixed with slightly warm water and taken twice a day, regardless of meals;
• crushed walnut partitions. With very rare urination, drop by drop or in small portions, take a teaspoon with a slide of powdered partitions. They can be taken with a glass of warm water. Similarly, it is recommended to use walnut leaf and bark powder. They are mixed equally for 8 g. They are taken up to 3 times a day, drinking plenty of warm water;
• birch leaves. 30 g of crushed dry birch leaves are poured into 1 liter of boiling white wine. The resulting mixture is returned to the fire and cooked under a closed lid, over low heat for another 15 minutes. After the specified time, the mixture is filtered so that leaves or sediment do not get into the finished solution, and left to cool at room temperature. Next, add 2 tbsp to the mixture. l. honey. The finished composition is stored in the refrigerator and taken in violation of urination, 80 ml 3 times a day. It is advisable to take the medicine 60-90 minutes after eating. It is not forbidden to use a decoction every hour for 1-2 sips;
• dog-rose fruit. Rosehip has long been known for its medicinal properties to combat urinary problems and inflammatory diseases of the genitourinary system. To prepare a medicinal tincture, you will need to fill half the glass container with crushed rose hips, from which all the bones are first pulled out. Next, the container is placed in a dark place and left to infuse for a week. Shake the container with the mixture from time to time. The finished tincture will acquire a light brown tint. If after a week the tincture is not ready, it is left for a few more days. The finished medicine can be filtered and poured into a clean container. Keep the tincture in the refrigerator or other cool place. Reception is carried out by 10 drops mixed with a tablespoon of slightly warm water twice a day before meals;
• duckweed powder. The powder can be purchased at a pharmacy or various health shops. The infusion is prepared in accordance with the manufacturer's recommendations. Use it in a tablespoon three times a day 30 minutes before meals, while drinking plenty of water.

In no case can not replace the medication. Medicinal decoctions and infusions can relieve pain and discomfort, as well as improve the patient's overall well-being. However, before using the listed folk remedies, it is recommended to consult a doctor.

Preventive measures to prevent urinary retention are to eliminate the factors that provoke the development of the disease. To do this, it is imperative to take care of your health and engage in timely treatment of infectious diseases. A man should be regularly examined by a urologist, and avoid injury and foreign objects entering the urinary tract. To prevent the formation of stones, you should follow the rules of a healthy diet and monitor the amount of alcohol consumed.

- This is a pathological condition characterized by a violation or impossibility of normal emptying of the bladder. Symptoms are pain in the pubic region and lower abdomen, very strong persistent urge to urinate and the resulting psychomotor agitation of the patient, a noticeable decrease in urine output or its absence. Diagnosis is based on a patient interview, the results of a physical examination, and ultrasound methods are used to determine the causes of the condition. Treatment - catheterization or cystostomy to ensure the outflow of urine, elimination of etiological factors of ischuria.

Urinary retention or ischuria is a fairly common condition that accompanies a significant number of various urological pathologies. Young men and women suffer from it in about the same way, as the age increases, male patients begin to prevail. This is due to the influence of pathologies of the prostate gland, which are usually determined in the elderly and are often manifested by urination disorders. Approximately 85% of all cases of ischuria in men over 55 are due to problems with the prostate. Urinary retention rarely occurs in isolation, more often it is part of a symptom complex caused by urological, neurological or endocrine pathologies.

The reasons

Urinary retention is not an independent disease, it always acts as a consequence of various pathologies of the excretory system. It should be distinguished from another condition, also characterized by the absence of urine output - anuria. The latter occurs due to damage to the kidneys, leading to the complete absence of urine formation. With urinary retention, fluid forms and accumulates inside the bladder cavity. This difference causes a different clinical picture, similar only in the volume of diuresis. The main reasons preventing the normal discharge of urine are:

• Mechanical blockade of the urethra. The most common and diverse group of causes that cause ischuria. These include strictures of the urethra, its obturation with a stone, tumor, blood clots, severe cases of phimosis. Blockade of the urethra can also be caused by neoplastic and edematous processes in nearby structures - mainly the prostate gland (adenoma, cancer, acute prostatitis).
• dysfunctional disorders. Urination is an active process, for the normal provision of which an optimal contractility of the bladder is necessary. Under certain conditions (dystrophic changes in the muscle layer of the organ, impaired innervation in neurological pathologies), the contraction process is disrupted, which leads to fluid retention.
• Stress and psychosomatic factors. Some forms of emotional stress can lead to ischuria due to inhibition of the reflexes that provide the process of urination. Especially often this phenomenon is observed in people with mental disorders or after severe shocks.
• Medicinal ischuria. A special type of pathological condition caused by the action of certain drugs (narcotic, sleeping pills, cholinergic blockers). The mechanism for the development of urinary retention is complex, due to the complex effect on the central and peripheral nervous system and bladder contractility.

Pathogenesis

Pathogenetic processes in different types of urinary retention are different. The most common and studied is mechanical ischuria, due to the presence of an obstruction in the lower urinary tract. These can be cicatricial narrowing (strictures) of the urethra, severe phimosis, urolithiasis with the release of calculus, prostate pathology. After some manipulations on the bladder (surgery, taking a biopsy of the mucosa) or bleeding in the urine, blood clots form, which can also obstruct the lumen of the urethra and prevent the outflow of urine. Strictures, phimosis, pathologies of the prostate usually lead to slowly progressive ischuria, while when a calculus or blood clot is released, the delay occurs abruptly, sometimes at the time of urination.

Dysfunctional disorders of the urinary tract are characterized by a more complex pathogenesis of urinary excretion disorders. Obstacles to the outflow of fluid are not observed, however, due to a violation of contractility, the emptying of the bladder occurs weakly and incompletely. Violations of innervation can also affect the sphincters of the urethra, as a result of which the process of their disclosure, which is necessary for urination, is disrupted. Stress, pharmacological variants of this pathology are similar in their pathogenesis - they arise reflexively due to disorders in the central nervous system. There is a suppression of natural reflexes, one of the manifestations of which is ischuria.

Classification

There are several clinical variants of urinary retention, differing in the suddenness of development and duration of the course. Each of these varieties, in turn, depending on the nature of the delay, is divided into complete and incomplete. With complete ischuria, emptying the bladder in a natural way is impossible, urgent medical intervention is required. With incomplete variants, urine output occurs, but very weakly, some volume of liquid remains inside the bladder. Each type of pathology also differs in etiological factors; in total, three variants of this condition are distinguished in clinical urology:

• Acute delay. It is characterized by a sudden abrupt onset, most often due to mechanical causes - obstruction of the urethra by a stone or a blood clot, sometimes a neurogenic variant of the condition is possible. With incomplete forms, there is a weak excretion of urine with pressure on the lower abdomen or a strong tension in the abdominal press.
• chronic delay. It usually develops gradually against the background of strictures of the urethra, diseases of the prostate, dysfunctions, tumors of the bladder, urethra. The rare complete form requires long-term (sometimes for several years) catheterization. In incomplete chronic forms, the amount of residual urine can reach large volumes - up to several hundred milliliters or more.
• Paradoxical ischuria. A rare variant of the disorder, in which, against the background of filling the bladder and the impossibility of voluntary urination, there is a constant uncontrolled release of a small amount of fluid. It can be mechanical, neurogenic or medicinal etiology.

There is a less common and more complex classification of urinary retention, based on their relationship with other diseases of the excretory, nervous, endocrine or reproductive systems. But, given the fact that ischuria is almost always a symptom of some disorder in the body, the relevance and validity of such a system remains in question. In some cases, different forms of the condition can turn into one another, for example, acute delay - chronic, complete - incomplete.

Symptoms of urinary retention

Any type of ischuria is usually preceded by manifestations of the underlying disease - for example, renal colic, due to the release of a stone, pain in the perineum associated with prostatitis, urination disorders due to strictures, etc. interrupted, further outflow of urine becomes impossible. This is how ischuria can manifest itself with urolithiasis or obstruction of the urethra with a blood clot - a foreign body is displaced along with the fluid flow and blocks the lumen of the canal. In the future, there is a feeling of heaviness in the lower abdomen, a strong urge to urinate, pain in the groin.

In acute incomplete ischuria, a weak thin stream may appear with strong abdominal tension or pressure on the suprapubic area. Urination brings almost no relief, since a significant amount of fluid remains in the bladder. After catheterization and treatment of the causes of ischuria, the symptoms completely disappear. Chronic urinary retention is rarely complete and usually develops gradually. Initially, patients may experience a decrease in urine volume, a feeling of incomplete emptying of the bladder, and frequent urination associated with this circumstance.

In the absence of progression of the causes of chronic incomplete ischuria, the symptoms may subside, however, studies reveal the retention of residual urine after each emptying, against this background, inflammation of the bladder mucosa (cystitis) often occurs, which can be complicated by pyelonephritis. The full variety of chronic urinary retention differs from acute only in the period of catheterization of the patient. In almost any form of delay, its first difference from anuria is the excited psycho-emotional state of the patient, due to the impossibility of urination.

Complications

Urination retention with a long absence of qualified assistance leads to an increase in fluid pressure in the overlying sections of the urinary system. In acute forms, this can cause the phenomena of hydronephrosis and acute renal failure, in chronic forms - chronic renal failure. Stagnation of residual urine facilitates tissue infection, therefore, the risk of cystitis and pyelonephritis increases.

In addition, with significant volumes of retained urine, conditions are created in it for the crystallization of salts and the formation of bladder stones. As a result of this process, a chronic incomplete delay is transformed into an acute and complete one. A relatively rare complication is the formation of a bladder diverticulum - a protrusion of its mucosa through defects in other layers, due to high pressure in the organ cavity.

Diagnostics

Usually, the diagnosis of "ischuria" does not cause any particular difficulties for a urologist, a simple questioning of the patient, examination of the suprapubic and inguinal regions is sufficient. Additional research methods (ultrasound diagnostics, cystoscopy, contrast radiography) are required to determine the severity and causes of the pathological condition, the choice of effective etiotropic therapy. In patients with chronic variants of ischuria, auxiliary diagnostics is used as a monitoring of the progression of the pathology and timely detection of urinary retention complications. The vast majority of patients use the following diagnostic methods:

• Questioning and inspection. Almost always they allow to determine the presence of acute urinary retention - patients are restless, complain of a strong desire to urinate and pain in the lower abdomen. On palpation of the suprapubic region, a dense filled bladder is determined; in lean patients, bulging can be noticeable from the side. Chronic incomplete varieties of the disorder are often asymptomatic, there are no complaints.
• Ultrasound diagnostics. In acute conditions, ultrasound of the bladder, prostate, urethra allows you to establish the cause of the pathology. A stone is defined as a hyperechoic mass in the lumen of the urethra or in the region of the neck of the bladder, but blood clots are not detected by most ultrasound machines. Ultrasound examination of the urethra, prostate can diagnose strictures, adenomas, tumors and inflammatory edema.
• neurological research. A consultation with a nephrologist may be required if neurogenic or psychosomatic causes of ischuria are suspected.
• Endoscopic and radiopaque techniques. Cystoscopy helps to determine the cause of the delay - to identify the stone, blood clots and their source, strictures. Retrograde cystourethrography is the gold standard in determining the amount of residual fluid, therefore it is used to diagnose incomplete forms of pathology.

Differential diagnosis is made with anuria - a condition in which the excretion of urine by the kidneys is impaired. With anuria, patients have no or sharply weakened urge to urinate, manifestations of acute or chronic renal failure are observed. Instrumental diagnostics confirms the absence or an extremely small amount of urine in the bladder cavity.

Treatment of urinary retention

There are two main stages of therapeutic measures for ischuria: emergency provision of normal urine outflow and elimination of the causes that caused the pathological condition. The most common method of restoring urodynamics is bladder catheterization - the installation of a urethral catheter, through which fluid is drained.

Under some conditions, catheterization is not possible - for example, with severe phimosis and strictures, tumor lesions of the urethra and prostate gland, "impacted" calculus. In such cases, they resort to cystostomy - the formation of a surgical access to the bladder and the installation of a tube through its wall, which is brought out to the front surface of the abdomen. If a neurogenic and stressful nature of ischuria is suspected, conservative methods of restoring the outflow of urinary fluid can be used - turning on the sound of flowing water, washing the genitals, injections of M-cholinomimetics.

The treatment of the causes of urinary retention depends on their nature: for urolithiasis, crushing and extraction of the calculus are used, for strictures, tumors and lesions of the prostate - surgical correction. Dysfunctional disorders (for example, hyporeflex type of neurogenic bladder) require complex complex therapy involving urologists, neuropathologists and other specialists. If the cause of ischuria is taking medications, it is recommended to cancel them or correct the drug therapy regimen. Urinary retention due to stress can be eliminated by taking sedatives.

Forecast and prevention

In most cases, the prognosis of urinary retention is favorable. In the absence of medical care, acute variants of the pathology can provoke bilateral hydronephrosis and acute renal failure. With the timely elimination of the causes that caused this condition, relapses of ischuria are extremely rare.

In chronic variants, the risk of infectious and inflammatory diseases of the urinary tract and the appearance of stones in the bladder increases, so patients should be regularly observed by a urologist. Prevention of urinary retention is the timely detection and proper treatment of pathologies that cause this condition - urolithiasis, strictures, prostate diseases and a number of others.