Residual urine in the bladder. Urine does not completely come out of the bladder: causes, treatment Residual urine is normal

Diseases of the genitourinary area are considered one of the most common among all pathologies in men. This is a whole group of diseases with similar symptoms. One of them may be residual urine - ischuria, when the bladder does not empty completely.

Normally, men may have an insignificant accumulation of urine (up to 50 ml). In the presence of pathological processes in the body, the volume of unremoved fluid can be up to 1 liter. This phenomenon can lead to serious complications (hydronephrosis, pyelonephritis). The first signs of urinary obstruction require early diagnosis and adequate treatment.

Causes of incomplete emptying of the bladder

In men, this syndrome can be a signal of the development of a number of diseases that cause difficulty in the outflow of urine through the urethra:

• Adenoma (benign hyperplasia) of the prostate - the prostate gland hypertrophies and causes compression of the urethra at its entrance to the bladder.
• Prostatitis - inflamed tissue of the prostate gland swells, the volume of intercellular fluid increases, and the urethra is compressed.
• Prostate tumor - can lead to the development of urinary retention only if the tumor grows into the urethra and reduces its diameter.
• Injuries, surgical interventions in the bladder area.
• Neurogenic bladder.
• Cystolithiasis - the presence of stones can cause ureteral obstruction and urinary stagnation.

Additional reasons for innervation may be:

• spinal cord damage;
• endocrine disorders;
• multiple sclerosis;
• enterocolitis;
• peripheral pathology nervous system.

To find out the reasons that cause stagnation of urine, a more thorough diagnosis may be required using laboratory and instrumental methods:

• general analysis urine, blood;
• blood biochemistry;
• urine culture with antibiogram;
• MRI and others.

Effective methods and general rules of treatment

To get rid of residual urine, you need to restore the patency of the urethra.

Since the pathological condition is a symptom and not a separate disease, normal urination can be restored only after its root cause has been eliminated:

• conservatively or surgically restore urinary tract patency;
• stop the inflammatory process;
• normalize the contractile function of the organ.

Etiotropic therapy

Its main task is to cure the disease that led to residual urine. When medications are prescribed that restore the ability to contract. For spasms, it is recommended to take muscle relaxants. If they do not have the desired effect, selective dorsal rhizotomy is performed. This is a dissection in the bundle of nerves of the spinal cord that provoke spastic contraction of the organ.

If incomplete emptying in men is caused by, treatment should include taking antibacterial drugs, which the doctor selects based on the type of pathogen. Antibiotics from the group of macrolides and fluoroquinolones are effective. Additionally, antispasmodics, diuretics, vitamins, immunomodulators, and dietary nutrition are prescribed.

For urolithiasis, treatment consists of removing the stones. Depending on the type, size, and shape of the stones, the doctor may prescribe conservative therapy using. But in most cases, surgical intervention is used, since drug therapy is ineffective in the presence of large formations and those that cannot be dissolved. An effective surgical treatment method is lithotripsy (using ultrasound or laser). The operation is low-traumatic and does not violate the integrity of the patient’s skin. Recovery after crushing occurs fairly quickly, without serious consequences.

To treat narrowing of the urethra, bougienage is often used - the introduction of special instruments into the urethra that widen it. This method does not eliminate main reason narrowing and gives only a temporary effect.

Catheterization

When a large amount of fluid accumulates in the bladder and it is impossible to empty it naturally, you have to resort to the catheterization method - inserting a rubber catheter into the urethra. The procedure is performed by a doctor in a hospital. Self-insertion of a catheter at home is prohibited.- high risk of bladder infection.

First, the urethral opening is treated with a disinfectant. The catheter is moistened with glycerin and inserted into the urethra using tweezers. Movements should be made progressively, gradually moving 2 cm at a time. The catheter should not be forcibly pushed forward. For some diseases (for example), such a procedure can lead to serious consequences.

Sometimes it may be necessary to install a permanent catheter. It should remain in the urethra for several days. To prevent infection, you should rinse the bladder with antiseptic agents (Furadonin, Nitroxoline). An oral antibiotic may be prescribed. If catheterization is impossible, the patient is referred to a urologist, where the issue of the possibility of surgical intervention to eliminate the cause of urinary retention will be decided.

Incomplete emptying of the bladder in men can signal the presence of various diseases. Prolonged stagnation of urine and disruption of its discharge ultimately causes disruption of the functionality of the entire urinary system. Early diagnosis and properly prescribed treatment will help get rid of the problem and maintain health.

The human bladder never empties completely: normally, after urination, a small amount of liquid remains in it. However, in an adult, the amount of residual urine should not exceed 50 ml, and in a child - 10% of the volume of the bladder.

Children (boys and girls):

• newborns - 2-3 ml;
• up to a year - 3–5 ml;
• 1–4 years - 5–7 ml;
• 4–10 years - 7–10 ml;
• 10–14 years - 20 ml;
• teenagers > 14 years old - up to 40 ml.

Adult men and women -

Residual urine is considered an important clinical sign: it indicates that some painful processes are occurring in the body that interfere with normal urination. In pediatric urology, this symptom is considered one of the most alarming and means that the child needs a full examination. For example, the presence of residual urine is the only clinical symptom of bladder diverticulum. With this disease, a sac-like protrusion forms on its wall, which can rupture and become inflamed if treatment is not started.

Stagnation of urine in the bladder is itself a painful condition that provokes bacterial inflammation and increases the likelihood of stone formation. Without treatment, symptoms increase every day. The volume of unremoved fluid increases, the bladder stretches and pain occurs, and over time, urinary incontinence develops.

Reasons

Residual urine appears for very different reasons, and not all of them are associated with pathologies of the bladder, ureters or urethra. They are divided into several groups:

• obstructive;
• inflammatory-infectious;
• neurological.

In the first case, we are talking about mechanical obstacles to the outflow of urine, which block the urinary tract from the inside or squeeze them from the outside. These include:

• narrowing and adhesions of the urethra;
• stones;
• malignant and benign tumors - polyps;
• prostate adenoma in men;
• uterine fibroids, ovarian cysts in women.

Inflammatory and infectious diseases provoke swelling of the urethra or spastic compression of the muscles of the bladder due to its reflex irritation. Residual urine often indicates cystitis, urethritis, prostatitis and balanitis in men.

Neurological causes are associated with a violation of the innervation of the bladder, that is, with the fact that the control of the central nervous system over urination is weakened. The bladder in such patients is completely healthy, and nothing interferes with the outflow of urine. But the muscular wall of the organ (detrusor) or the muscle that locks the urethra (sphincter) no longer senses when to contract. This condition is called “neurogenic hypotonic bladder” and can be caused by:

• multiple sclerosis;
• congenital defects of the central nervous system, especially in children;
• spinal cord or brain injuries;
• diseases of the spine (disc herniation, osteochondrosis, radiculitis, tumor).

The tone of the organ weakens under the influence of certain medications: antidepressants, muscle relaxants, antiarrhythmics, diuretics, hormonal drugs, drugs for Parkinson's disease, narcotic painkillers.

Symptoms

With inflammation and blockage of the urinary tract, residual urine is just one of many symptoms of illness, and it is detected during examination for these diseases. But if it appears as a result of neurological disorders, it is more difficult to diagnose the pathology, especially in a small child.

The first sign that a person, despite being in good health, suffers from urinary retention is a mild, sluggish urge to urinate. The symptom develops gradually, along with increasing atony of the bladder. Other signs that suggest something is wrong include:

1. Feeling of pressure in the bladder. In a child who cannot yet talk about his sensations, it is enlarged and painless.
2. Sluggish or intermittent stream of urine.
3. Pain in the urethra.

With a diverticulum, there is no pain or pressure, but the person urinates “in two stages”: first with a large portion, and then with a scanty one. This happens because first the bladder itself is emptied, and then the diverticulum formed on it.

Diagnostics

Diagnosis of urinary disorders consists of a survey, laboratory diagnostics, urological and neurological examination. At the first appointment, the urologist prescribes:

• clinical blood and urine tests, urine culture to determine bacterial infection;
• ultrasound examination of the bladder, pelvic organs (prostate in men and boys, uterus and ovaries in women and girls);
• if necessary, cystoscopy and urodynamic study (contrast urography).

Cystoscopy gives the most reliable answer about whether there is residual urine in the bladder and what its volume is. But this method of examination is quite traumatic, so it is used only as a last resort, especially in a child.

Ultrasound examination is carried out in two stages: with a full bladder and after urination. The doctor measures the volume and size of the full bladder, then the patient empties it, and within 5-10 minutes after urination, the ultrasound is repeated. The amount of liquid is calculated using special formulas, taking into account the height, width of the bubble and the length of its ultrasound shadow. To increase the accuracy of the results, measurements are carried out at least three times.

If you or your child are taking diuretics or have recently eaten foods or drinks that irritate the bladder (spicy, smoked, salty, coffee, soda, strong tea), tell your doctor. After taking diuretics, up to 100 ml of liquid accumulates in the bladder within 10 minutes, and the diagnosis will be erroneous.

Emergency bladder emptying

When a lot of fluid accumulates in the bladder and the patient is unable to empty it naturally, he undergoes catheterization. People for whom the procedure is contraindicated, for example, with urethral sphincter spasm, may be given an injection of botulinum toxin into the sphincter area to relax the muscle.

In some cases, the patient is given a temporary urethral stent with a validity period of three to six months. It is a cylinder of thin (1.1 mm in diameter) wire spiral made from organic material, which soon dissolves.

Treatment

The presence of residual urine is only a symptom, not a disease. Therefore, in order to establish normal urination, you need to deal with the reason that disrupts it:

• surgically or conservatively (for urinary tract disease) to restore patency of the urinary tract;
• remove inflammation;
• normalize bladder contractility.

The most complex treatment will be needed for neurological disorders. It can be medicinal and surgical.

If the bladder is atony, the doctor prescribes medications to the patient that will help restore its ability to contract. When it spasms, the patient is prescribed muscle relaxants. If it is not possible to relieve spasms with medication, a surgical operation called “selective dorsal rhizotomy” is performed. It consists in the fact that the doctor identifies in the bundle of nerves of the spinal cord those that cause spastic contraction of the bladder and dissects them.

Residual urine in men is not a disease, but a symptom that may indicate chronic urinary retention. This is the liquid that remains in the bladder after urination.

Special attention When diagnosing, one should pay attention to the volume of fluid that is not excreted. The normal volume of residual urine is considered to be 50 milliliters and can be observed even in quite healthy person, the maximum limits can exceed a liter.

This symptom usually develops gradually, progresses over time, and the volume of fluid that is not excreted increases.

People who are diagnosed with this symptom usually complain that they do not feel a complete emptying of the bladder after they pass a little. Sometimes the act of urination becomes intermittent and the bladder is emptied only on the second attempt with additional contraction of the abdominal muscles. However, there are cases when, despite the presence of a symptom, the patient makes absolutely no complaints.

If fluid remains in the body after a bowel movement, consult a doctor immediately

This condition has many causes. Among them are diseases such as adenoma, fibrosis, tumors, nerve lesions and so on.

This symptom is also dangerous due to complications that can be caused by the presence of retained fluid in the body. So, a person can develop pyelonephritis, stones form, reflux, diverticula and even hydronephrosis.

Symptoms

The first thing you should pay attention to if you suspect retained fluid in the bladder is a dull urge to urinate. Of course, this symptom develops gradually, along with urinary atony. Oddly enough, patients do not feel any pain, they have no reaction to the fact that urination is delayed. And in vain... Time may be lost and the disease will go into the second stage. And it threatens with degeneration and dystrophy of nerve receptors. Almost every case of such fluid retention ends in kidney dysfunction. At the second stage, patients often complain of:

• lumbar pain
• fever
• chills

Changes in the composition of the blood also begin, leukocytes increase. Often, this symptomatology becomes a reason to conduct an examination for the presence of urosepsis, which often becomes malignant.

If you notice at least one of the symptoms described above, immediately seek help from a specialist. Only in a hospital setting can you have your urine urgently drained using a trocar puncture.

Diagnostic and therapeutic measures

Large residual urine is detected by palpation and percussion of the area above the pubis. If the volumes are not too large, it is possible to perform an ultrasound of the urinary tract after urination.

2016-10-18 13:43:02

Nadezhda asks:

Hello! Frequent urination during the day (especially when shaking or active walking) is a concern. At first they diagnosed OAB, but then they understood the symptoms in more detail (I don’t have imperative urges + if I sit comfortably, I can tolerate it for 2 hours), but when I travel in public transport or walk quickly the situation worsens, so they made another diagnosis - uraturia. I took tests: OAM (everything is normal except for the presence of an increased number of red blood cells and protein, and urate salts) + urine test according to Nechiparenko (red blood cells 3000! when the norm is 1000). LHC culture of urine and gynecological - clean. Ultrasound of the kidneys and bladder (there are a lot of microliths in both kidneys measuring 1-2 mm, the passage of urine is not disturbed, residual urine is normal (after urination), the renal pelvis is visualized at 1.6 cm (the doctor said that Normally, they are not visible on ultrasound). I take blemaren and keep the urine pH in the region of 7-7.2 (1.5 months) so far without any effect. The doctor prescribed phytolysin paste. Now with every urination I see sand + sometimes microliths of 1 mm in size (transparent white) come out. I have removed all meat and fish broths from my diet, tea (I only drink herbal and rosehip decoctions with lemon), natural coffee, I eat only chicken (breast) 2 times a week. After taking phytolysin, my lower back begins to ache a little, but without acute pain. There are three questions: 1. Why are the renal pelvis visible on an ultrasound? 2. How long can sand come out if there is a lot of it and how quickly does it form? 3. Could I “collect” sand in the kidneys during pregnancy, since the problems began? six months after the birth of the child?

Answers Zhosan Dmitry Alexandrovich:

Hello. #Cavity systems of the kidneys can always be seen on ultrasound. #Increased sand discharge may indicate that the metabolism is disturbed, I advise you to take a more careful look at the issue of nutrition (first, consult a nutritionist-nutritionist). Do not forget about drinking 1.5-2 liters of water per day. #I advise you to review your salt transport.

2015-10-12 11:32:44

Anton asks:

Hello. I’m 32 years old. Help me decipher the ultrasound.
ultrasound of the prostate gland:
The prostate gland is round in shape. The capsule can be traced throughout. Dimensions: 3.30*2.52*2.83 cm. The central part of the gland is not enlarged. The peripheral sections are not compressed by the central zone. Echogenicity is normal. The internal structure is heterogeneous due to elements of fibrous heaviness. the prostatic part of the urethra is not dilated. It does not protrude into the bladder. Seminal vesicles without features.
Ultrasound of the bladder:
The bladder is filled to a volume of 272.0 cc. The volume of residual urine is 7.0 cc. Wall thickness 0.3 cm. Contents homogeneous liquid. conclusion: Diffuse changes in the prostate gland.
Ejaculate analysis:
research method: manually
abstinence time: 4 days
Ejaculate quantity:5ml
ejaculate color: cloudy yellow
Ejaculate pH: 8
Ejaculate viscosity 5.0 cm
Ejaculate liquefaction time 60 min
Number of sperm in 1 ml 67 million
Number of sperm in the entire volume 335 million
Mobile sperm 28%
Sedentary sperm 18%
Still sperm 54%
Slime +
Spermatogenesis cells 2-3 in p/zr
Agglutination -
leucithin grains are few
Leukocytes 7-10 in p/zr
Pathological forms 65%

Answers Sudarikov Igor Vitalievich:

Good morning, Anton! It is very difficult to comment on the ultrasound findings without seeing the images. The only thing that can be stated is that fibrosis occurs as a result of the inflammatory process. This is also confirmed by an increase in the number of leukocytes in sperm. I think that this was the reason for a moderate decrease in sperm motility and an increase in the percentage of pathological forms. Best regards, Dr. Sudarikov.

2014-10-14 20:27:21

Albina asks:

Hello, with the onset of cold weather I felt discomfort when urinating, pain, burning, after emptying, there was a feeling below as if the bladder was inflating like a balloon and again a feeling of a full bladder and a desire to go to the toilet, I got sick with the flu: when I blew my nose too much I felt like a drop urine was released. I did a general analysis of urine and blood - the presence of inflammation did not show. I went to the gynecologist: they diagnosed chronic inflammation and prescribed: IV sodium thiosulfate, rectal ichthyol suppositories, Texamen tablets, a week after receiving the smear test, they prescribed neo-penotran L suppositories, which I so I didn’t buy it, and I didn’t make it. I went to the urologist with my tests, they prescribed tests for: ureoplasma and chlamydia PCR, which were negative, and a cystoscopy, which I did not go for because of my period. The burning sensation and the first symptoms went away, but the desire to go to the toilet little by little, after I recently went, remains. Question: is it worth doing a cystoscopy? I doubt the sterility of this procedure, they will get infected with something, and is there any need at all? Suddenly it’s all connected with inflammation in women and weakened immunity with the flu. As a child, I had cystitis, after uremetry I was diagnosed with hyper-reflex non-adaptive bladder. Maybe these are residual effects after cystitis?

Answers Mazaeva Yulia Alexandrovna:

Albina, good afternoon! I think you can refrain from cystoscopy, just do an ultrasound of the bladder. You have symptoms of cystalgia and hyperreflex bladder. Be healthy!

2014-09-23 16:00:33

Katerina asks:

Hello! Since 2003 I have been seeing a psychiatrist. Neurotic depression with insomnia (I have difficulty falling asleep, the quantity and quality of sleep is poor). I took azaleptol and amitriptyline for a long time. In January of this year, sonapax and quetiron were offered at the day hospital. But in the summer, side effects from the drugs began to appear, and urinary retention began. At first I couldn’t cure cystitis for a long time, only after the 4th course of antibiotics did I cure it. Then there was a strong urge to urinate. I contacted the Institute of Urology: they did an ultrasound to determine residual urine - much higher than normal, they did uroflowmetry - it showed a delay in urination in the bladder. The urologist explained to me that this is happening to me from taking psychotropic drugs.
Please advise what to do and where I can turn for qualified help, where they can help me choose the right medications that will not cause urinary retention and promote sleep?
The urologists did everything they could. I'm still taking tamsulide to make urine flow easier (sometimes no-shpu during spasms).
One psychiatrist said that it is rare for anyone to experience such side effects from psychosis. drugs, in particular azaleptol, etc. Although drugs with anticholinergic side effects lead to neurovegetative disorders such as urinary retention, disrupting normal contractions of the sphincters. (This is especially true for tricyclic antidepressants). So far they have prescribed Miaser and, in addition to it, Sonovan and Gidazepam.
But how much this will help me and for how long, I don’t know! Please advise what to do so that I can sleep and avoid side effects from the medications?

2014-07-03 16:34:23

Katerina asks:

In mid-April, a strong and frequent urge to urinate began. I went to the doctor, took a urine test, the doctor said that the test was normal, there were no bacteria, although they found sand and oxalates. Prescribed urotol and monural.
After the monural, things got better. (I took the antidepressant amitriptyline, which can cause the urge to urinate, like side effect, but now I don’t drink it). A week and a half later, such urges appeared again, but a little weaker.
Sometimes I felt a slight spasmodic-scratching pain either in the area of ​​the right or left kidney and in the lower abdomen in the area of ​​the bladder.
The other day I went to another urologist. After a conversation with him, looking at my analysis, and in addition an ultrasound of the kidneys and urine. bladder from a year ago, said that according to the analysis and ultrasound, he doesn’t see anything wrong, it’s polyuria of a nervous nature (neurogenic bladder) and you need to drink a sedative, or polyuria of a medicinal nature (I take quetiron at night or Sonapax was prescribed by a psychiatrist. I read in the instructions for quetiron, that this drug somehow affects the antidiuretic hormone.)
I consulted with a psychiatrist, who said that the drugs I am currently taking (Sonapax and gidazepam) cannot cause polyuria. He added that most likely this is an infection, and when there is sand, this is fertile ground for infections.
I had to go to another urologist, who was recommended by my psychiatrist. They did an ultrasound - chronic cystitis and urinary diathesis. Urine culture showed E. coli 105 cu/ml. They prescribed Ceforal 400 mg No. 10 times a day, Fucis 150 mg on the 8th day, Flavia 2 capsules a day for 30 days (it lasted only 15 days, it is highly diuretic.)
A urine test showed bacteria. They prescribed cyprinol 500, 2 tablets a day for 10 days, and cystinol, 2 tablets 3 times a day for 10 days. It became easier. I took another test - no bacteria were found. But the analysis revealed significant amounts of oxalates. The urges have not completely disappeared. The doctor said that this is a residual phenomenon, and oxalates cannot cause urges. She prescribed Urotol 1 mg for 1 month.
(At night it was so bad that I didn’t sleep and ran to the toilet every hour, maybe I drank a lot of liquid and also got nervous.)
Could this be a residual phenomenon? Or is it the salts that cause this? Or is it on nervous soil? Please advise what to do? How to get rid of oxalates? Maybe contact the Institute of Urology?
I'm very worried about this.

Answers Mazaeva Yulia Alexandrovna:

Good afternoon, you actually have a neurogenic, hyper-reflex bladder and cystalgia - a complex symptom complex, the causes of which can be nervous or hormonal, more often referring to female sex hormones, of origin.

2014-03-21 17:13:59

Leonid asks:

Please tell me whether the urologist prescribed the correct treatment for me for prostate adenoma with complaints of difficulty urinating in the morning and insufficient erection? Ultrasound data: the bladder contains 500 ml of urine. It is symmetrical. The walls are not thickened. The internal contours are smooth. The lumen is homogeneous. Residual urine is 100 ml. The prostate gland is enlarged - 5.6 * 4.9 * 4.4 cm / volume - 63.0 cubic cm. Protrudes into the lumen of the urinary bubble. The contours are even. The capsule is pronounced. The central part is enlarged, the structure is nodular. The parenchyma is of normal echogenicity. Diffusely heterogeneous due to calcifications. Total PSA - 8.9 ng/ml. Free PSA - 1.58 ng/ml. Ratio - 17%. Testosterone - 20.25 nmol/l. I was prescribed: Focusin to drink for two months, Phlebodia for a month, prostatilen suppositories. From the second month Pravenor or Gentos. Age: 52 years old.

Answers Vladychenko Konstantin Anatolievich:

Hello. I think right. Moreover, the doctor probably recommended monitoring a blood test for PSA, as well as repeating an ultrasound of the prostate and bladder after the course of treatment. Comparison of the examination results will provide data for further tactics (an ultrasound-guided biopsy may be recommended).

2013-12-04 09:39:20

Gulya asks:

Dear doctors! I ask for advice on what to do. Since July I have had increased red blood cells in my urine. In the summer, symptoms of frequent urination appeared. I turned to a urologist in the summer. Treatment with flemoklav was prescribed based on urine analysis, in which leukocytes were normal, red blood cells 8-7-8, bacteria ++, mucus ++. After treatment there were no changes, red blood cells were still present. I went to another urologist and Suprax was prescribed, based on culture data. Again, no changes - there are 10-12 red blood cells in the urine in the field of view. Ultrasound of the kidneys and bladder: no pathology, residual urine volume - 10 ml. The third urologist performed a cystoscopy and visually determined the presence of leukoplakia in the area of ​​the bladder neck measuring 2 by 2. Furamag, Trental, Triovit, Urotol were prescribed. While taking urotol, the number of urinations per day decreased slightly, approximately once every 2-3 hours. I don’t get up to go to the toilet at night, very rarely. There is no swelling, no increase in blood pressure, no temperature. There is no protein in the urine either. Yesterday's urine test showed the presence of 50-60 red blood cells. Leukocytes 0-1. There is also an analysis of the glomerular filtration rate - the value is within the normal range (I don’t remember the exact numbers). Daily albuminuria is normal.
The observing endocrinologist suspects glomerulonephritis. But the urologist says that it is unlikely, because... there is no protein in the urine. Can you tell me in which direction I should be examined now?
Thanks in advance.

Answers Klofa Taras Grigorievich:

You are shown: 24-hour urine test for protein content, thorough ultrasound of the kidneys and bladder, and, if necessary, excretory urography

2013-08-17 15:20:02

Gulya asks:

Hello! I already wrote about my situation on August 13th. I didn't have a cystoscopy. Ultrasound of the bladder: oval shape, the wall is 3 mm clear throughout. The cavity has no features. After mixing, 10 ml of contents. Currently there is heaviness in the lower abdomen, which is sometimes less, sometimes more. Frequent urination, I get up to go to the toilet once at night.
I took a course of Suprax 400 mg. I haven’t given urine yet after that. I take canephron, a decoction of bearberry. I visited two urologists, one diagnosed it as chronic. latent cystitis, other hemorrhagic cystitis, subsiding exacerbation. There were 1-15 red blood cells in the urine in the urine. In the bacterial culture there is a quiche. stick 10 in 5-10 in 6 tbsp. Please tell me what direction I should move next, what treatment is possible. Thank you. Gulya. 13.08. “Dear doctors! I really ask for advice. In June, I began to experience frequent urination. There are red blood cells and bacteria in the urine. The urologist prescribed antibiotics for 5 days, flemoklav. After treatment, the bacteria disappeared, the red blood cells remained, the sensations also remained: frequent urination, heaviness in the abdomen. For some time, the urologist said to drink nettle - no changes, red blood cells in the urine 10-15 in the field of view. Another urologist, based on the results of bacterial culture (Escherichia coli 10 in 5 - 10 in 6 st.), also prescribed suprax for 7 days. Also no significant changes: frequent. urination, feeling of fullness of the bladder. According to ultrasound, residual urine is 10 ml. What do you advise me to do? I’m tired of the constant desire to go to the toilet. I feed the child a little more (only at night). Urologists say that while I’m feeding there is nothing special to treat me. stop feeding - as long as they start treating me. Thank you." Doctor's answer: "Ultrasound of the bladder???

2013-08-13 09:22:37

Gulya asks:

Dear doctors! I really ask for advice. In June I started urinating frequently. There are red blood cells and bacteria in the urine. The urologist prescribed antibiotics for 5 days and a flemoclav. After treatment, the bacteria disappeared, the red blood cells remained, and the sensations also remained: frequent urination, heaviness in the abdomen. For some time the urologist said to drink nettle - no changes, red blood cells in the urine 10-15 in the field of vision. Another urologist, based on the results of bacterial culture (E. coli 10 in 5 - 10 in 6 samples), prescribed Suprax for 7 days. Also no significant changes: frequent urination, feeling of fullness of the bladder. According to ultrasound, residual urine is 10 ml. What do you advise me to do? Tired of constantly wanting to go to the toilet. I feed the child a little more (only at night). Urologists say that while I feed, there is nothing special to treat me with. But I’m ready to stop feeding - if only they would start treating me. Thank you.

Answers Brezitsky Yuri Iosifovich:

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Represents intermittent urination or a feeling of incomplete emptying. If the delay occurs abruptly, then this is a sign of an acute form of manifestation. With the increasing development of the disease, they speak of a chronic course of the disease. Residual urine in the bladder of a man or woman is less than 50 ml - the norm, and a person, as a rule, does not feel it.

The structure and mechanism of the bladder

Depending on the amount of urine accumulated, the bladder expands or contracts. The accumulation process itself occurs sequentially. The first urge to urinate appears already when 150 ml has accumulated. In adults, the volume of the bladder is 250–500 ml. For some people, the norm reaches 750 ml. The extensibility of the walls of a muscular organ is predetermined by the structural features of the muscles.

The basis of the muscular membrane of the bladder is the detrusor muscle, a muscle that expels urine. The shell consists of 3 layers, and the detrusor is a combination of longitudinal and spirally twisted fibers. There are 2 ureters that empty into the bladder and carry urine through them. The lower part of the bladder narrows, gradually passing into the urethra, and is called the neck.

Externally, the excretory canal differs in women and men. The male duct is long and narrow (30/8 mm). For representatives of the weaker half, it is short and wide (4/15 mm). In a child during intrauterine development, the formation of the bladder occurs at 7 weeks.

The mechanism of action of an organ is determined by the functions it is designed to perform. There are only two of them:

• cumulative;
• excretory

When the physiological norm of capacity is reached, the bladder should empty. In this case, neuro-reflex mechanisms are activated, sending an impulse to the detrusor to contract it. Our usual process occurs in two stages under the control of the spinal cord and brain. When the bladder is filled to a certain level, urine output does not immediately occur. When a second impulse appears, which signals the sphincter that holds urine to relax, it comes out. Newborn children who have not been taught the act of urination develop enuresis.

Causes of bladder dysfunction

The health of the bladder depends on the processes occurring inside its mucous membrane, and dysfunction of the organ in an adult significantly changes the quality of life. The causes of impaired urination differ depending on gender and due to the specifics of the disease.

A common female problem is cystitis. The disease has an infectious status and is associated with the female anatomical structure. When the mucous membrane becomes inflamed, a symptom appears such as incomplete emptying of the bladder in women. Difficulty urinating in men is associated with inflammatory processes and changes in the prostate or kidneys.

The products of inflammation, in addition to the mucous membrane, affect the muscle layer and nerve elements. As a result, the urge to urinate occurs in a smaller capacity, therefore, the bladder is not completely emptied, and the person visits the toilet more often. If the symptoms of the disease are accompanied by severe pain and the person does not seek treatment for a long time medical care, neuroses develop.

The causes of incomplete bladder emptying in men are:

• neurological diseases;
• prostatitis;
• prostate adenoma;
• urethral tumor;
• cancer of the prostate gland and other organs;
• drug intoxication.

A decrease in muscle tone of the urinary organ and incomplete removal of fluid indicate not only pathologies of the pelvis, but also diseases of other organs. Diseases of the spinal cord impair the excretory function of the bladder. These include:

• mechanical injuries of the spine;
• multiple sclerosis;
• radiculitis.

Overactive bladder

Increased pulsation of the brain against the background of appendicitis and pyelonephritis also causes a residual phenomenon in the bladder. This means that during the act of full urination, the brain receives an impulse that there is a residue in the bladder that needs to be eliminated. Then there is an erroneous urge to urinate.

Diseases of the central nervous system that cause residual urine in the bladder in men and women include myelitis, dysfunction of the spinal cord and brain.

The feeling that urine remains in the bladder may have psychological causes - prolonged stress, shock.

Residual urine can increase in various diseases of the urethra, when free excretion is impaired and there are obstacles. Most often this occurs after injury, chemical burns urethra, which leads to narrowing of the organ and scarring.

Important signals of distress

Symptoms of difficulty urinating are:

• feeling of incomplete emptying of the bladder or weakness of urination;
• jet splitting;
• pain and discomfort;
• general malaise;
• erectile dysfunction;

Incomplete bladder emptying in men is rarely a separate disease. Pathology is evidence of another disease - prostatitis or prostate adenoma. In women, such disorders are a sign of cystitis or urethritis, occurring in acute or chronic form, postpartum complications or genital herpes.

Urethral stones are a pathology that develops against the background of a feeling of incomplete emptying of the bladder and prolonged symptoms. Stones cause dysuria, signal blood in the urine, form in the ducts and cavities, disrupting the natural cycle of formation and excretion of urine.

Symptoms should not be taken lightly. Incompletely excreted urine can become a source of bacterial damage and inflammatory reactions. If the listed symptoms appear, a visit to the doctor cannot be postponed for a long time. Otherwise, serious complications are possible that are difficult and long to treat.

Diagnosis and treatment

When symptoms of incomplete bladder emptying occur in men, treatment consists of identifying the underlying disease. Diagnosis is carried out by laboratory testing of urine, ultrasound, urethroscopy. If necessary, a hormonal examination of the prostate gland is prescribed. When the symptoms of difficulty urinating disappear, they talk about correctly selected complex therapy, including:

• relieving inflammation with antibacterial agents;
• surgical treatment.

Surgical removal is prescribed for adenoma and prostate cancer. Therapeutic treatment is carried out when prostatitis is detected. If the condition of incomplete emptying occurs as a result of an infectious lesion in a man, the woman is prescribed antibiotics.

If there are stones in the excretory organ, it is prescribed medicines, aimed at dissolving or releasing elements. If the reason lies in the patient’s psychoneurological condition, sedative medications are prescribed.

If a child has difficulty urinating, it is necessary to wait for the results of blood and urine tests, which often confirm inflammatory processes. If a woman has a feeling of incomplete emptying in the presence of a gynecological disease, efforts are aimed at eliminating the root cause with the help of specific therapy.

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