SURGICAL DISEASES, TRAUMATOLOGY, ORTHOPEDICS, UROLOGY : URINARY RETENTION (CONTINENTIO URINAE) - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
The impossibility of self-urination in the presence of urine in the bladder. There are complete retention of urine, in which the patient is completely unable to urinate, and incomplete, when urination occurs, but the bladder is emptied only partially, part of the urine (greater or lesser) remains in the bladder (residual urine). Urinary retention can be acute when it occurs suddenly and can then stop or go in chronic incomplete; may be incomplete, and then gradually move in full. Difficulty urinating unlike delay call such a state, in which, in spite of the sick difficulty during urination, the bladder is still empty. Causes of urinary retention can be:
1) mechanical nature of the obstacles in the neck of the bladder or in the urethra (the stones, narrowing and damage to the urethra, hypertrophy and inflammatory diseases of the prostate);
2) lesions of the Central nervous system (parasiticides diseases of the nervous system (spinal cord the " dryness " and other), traumatic injury to the spinal cord);
3) reflexive nature spasms due to surgery or inflammatory processes in the area of the perineum, rectum, and female genital organs.
If the obstacle is of a mechanical nature is slow (for example, when the stricture of the urethra), bladder responds hypertrophy of muscles. Further gallbladder muscle gradually weakens the bladder is stretched, sometimes to a large extent it appears residual urine, and further the total delay.
Symptoms. Patients experiencing an imperative urge to urinate, pain above the pubic area, perineum and rectum, in more severe cases, fever, cold clammy sweat. They take all kinds of provisions, sometimes there comes an involuntary defecation. Objective and accurate symptom is stupidity above the pubic area defined by the percussion.
Recognition should be first and foremost in the establishment of latency. You should continue to establish the cause of urinary retention (anamnesis). To exclude anuria, difficulty urinating. For urinary retention associated with lesions of the Central nervous system, characterized by the absence of complaints. Careful study of the nervous system.
Acute retention of urine - emptying of the bladder catheter. If the latter is impossible, suprapubic puncture. Further treatment is to eliminate the reasons causing the delay.