loading...

Urinary symptoms-lower urinary tracts symptoms

ENLARGED PROSTATE

INCREASED FREQUENCY OF URINE

Frequency is the number of times a person pass urine .Increased frequency may be caused by residual urine(left over urine in bladder after passing urine), fibrosis(leads to loss of elasticity or distensibility) of the bladder caused by tuberculosis, radiation cystitis, interstitial cystitis.The presence of stones may cause bladder irritability resulting in increased frequency.In infections the desire to urinate may be constant, and each voiding may produce only a small amount of urine. Day frequency without nighttime frequency and acute or chronic frequency lasting only a few hours suggest nervous tension. A very acidic or alkaline urine can irritate the bladder and cause frequency of urination.

URGENCY OF PASSING URINE

A strong, sudden desire to urinate is caused by hyperactivity and irritability of the bladder, resulting from obstruction, inflammation, or neuropathic bladder disease. In most circumstances, the patient is able to control temporarily the sudden need to void, but loss of small amounts of urine may occur (urgency incontinence). URINE LEAK/STRESS URINARY INCONTINENCE/URGE INCONTINENCE/OVERFLOW INCONTINECE When slight weakness of the sphincteric mechanisms is present, urine may be lost in association with physical strain (eg, coughing, laughing, rising from a chair).This is common in multiparous women who have weakened muscle support of the bladder neck and urethra and in men who have undergone radical prostatectomy. Occasionally, neuropathic bladder dysfunction can cause stress incontinence. The patient stays dry while lying in bed. BURNING and PAINFULL URINATION/Dysuria Dysuria often is the first symptom suggesting urinary infection and is often associated with urinary frequency and urgency.Painful urination is usually related to acute inflammation of the bladder, urethra, or prostate. At times, the pain is described as “burning” on urination and is usually located in the distal urethra in men. Women usually localize the pain to the urethra. The pain is present only with voiding and disappears soon after micturition is completed. More severe pain sometimes occurs in the bladder just at the end of voiding, suggesting that inflammation of the bladder is the likely cause called terminal dysuria.. Pain also may be more marked at the beginning of or throughout the act of urination. INCREASED FREQUENCY OF URINE AT NIGHT Increased frequency of urination at night is called -Nocturia .It may be a symptom of kidney disease Nocturia can occur in persons who drink excessive amounts of fluid in the late evening eg. Coffee and alcoholic beverages. In older people some fluid retention may develop as leg and ankle swelling secondary to mild heart failure or varicose veins.when they lie down to sleep or rest at night, this fluid is mobilized, leading to nocturia .Nocturia causes poor sleep and day time tiredness and drowsiness.

BED WETTING/Enuresis

enuresis means bedwetting at night. Bedwetting is normal during the first 2 or 3 years of life. Bedwetting after 7 years needs evaluation and treatment.It may be functional or due to delayed neuromuscular maturation of the urethrovesical component.It may also present as a symptom of eg, infection, distal urethral stenosis in girls,posterior urethral valves in boys, neurogenic bladder.

TERMINAL DRIBBLING

Terminal dribbling becomes more and more noticeable as obstruction progresses and is a most distressing symptom. LOSS OF FORCE AND DECREASE OF CALIBER OF THE STREAM Progressive loss of force and caliber of the urinary stream is noted as urethral resistance increases despite the generation of increased intravesical pressure. This can be evaluated by measuring urinary flow rates; in normal circumstances with a full bladder a maximal flow of 20 mL/s should be achieved. SENSE OF RESIDUAL URINE URGENCY The patient often feels that urine is still in the bladder even after urination has been completed. STRESS INCONTINENCE/URINE LEAK When slight weakness of the sphincteric mechanisms is present, urine may be lost in association with physical strain (eg, coughing, laughing, rising from a chair).This is common in multiparous women who have weakened muscle support of the bladder neck and urethra and in men who have undergone radical prostatectomy. Occasionally, neuropathic bladder dysfunction can cause stress incontinence. The patient stays dry while lying in bed. BLOOD IN URINE/HEMATURIA Normal urine has no blood in it. Presence of blood in urine can be gross or microscopic(not visible by naked eyes).Presence of blood in urine will make it pink to dark red in appearance.Sometimes bleeding can be severe to cause clots in urinary bladder and may cause retention of urine.Blood in urine can occur after heavy excersices like running/jogging.Stone or infection are common cause of blood in urine in young patients,in elderly tumors of the kidney,bladder and prostate has to be considered.