Problems with the bladder (detrusor) usually arise as a result of dysfunction of an important organ. Prolonged course of the disease leads to the development of serious complications. Women suffer from problems with the urinary (urinary) bladder more often than men, due to the structural features of the body.
The most common diseases that cause difficulty urinating are inflammatory processes, malignant tumors, metabolic disorders in the form of urolithiasis. In men, detrusor pathology is not treated as effectively as in women, and often leads to the development of a chronic process.
Causes of dysfunction
Bladder control problems come to the fore in women who have an overactive bladder. The disease occurs after an infection, stress, or injury. In many cases, involuntary contraction of the detrusor muscle wall and weakening of the external sphincter are observed.
Cystitis (inflammation of the bladder) is often accompanied by uncontrolled urine production. Discomfort may occur while sleeping, sneezing or coughing. In this case, urine is released in small portions. Often the problem is that the patient has difficulty starting urination or the detrusor does not empty completely.
Acute symptoms appear as a result of the progression of the following diseases:
Medicines to treat bladder inflammation in women
- cystitis;
- herpes;
- urolithiasis;
- hormonal disorders.
Often, a patient experiences a weakening of the muscle tone of the detrusor walls after a spinal cord injury or disease. Symptoms indicating bladder dysfunction are varied. A woman complains of involuntary urine discharge, pain, burning, and the appearance of flakes in the urine.
In some cases, the first symptoms disappear after a few weeks, but the disease has a strong impact on the general condition of the patient. After long-term ineffective drug treatment, women may experience new complications, and often the pathological process ends with rupture of the detrusor walls. Spontaneous release of urine occurs when the bladder is as full as possible.
Treatment of tuberculosis
Diagnostic measures are still the same. They are listed above. What about therapy? Tuberculosis of the genitourinary system requires long-term treatment in special, specialized dispensaries. Usually it takes 2-3 years. Yes, it takes a very long time, but such treatment helps to achieve stable remission, and also has a better effect on the quality of life.
As in all other cases, the treatment regimen is drawn up on an individual basis. The doctor must take into account the stage of the disease and other physiological characteristics of his patient. Be that as it may, a complex regimen of antibiotics combined with anti-tuberculosis drugs is usually prescribed.
The following medications demonstrate the greatest effectiveness:
- "Protionamide".
- "Ethambutol."
- "Isoniazid".
- "Rifampicin."
- "Pyrazinamide".
Often these drugs are combined with fluoroquinolones. Ofloxacin is usually prescribed.
It is important to keep the dynamics of the disease under control. To do this, the patient must regularly donate urine so that it can be examined in a laboratory.
In the event that tuberculosis is in an advanced state, and it is already fraught with pathological changes in organs, there is no way to do without surgery. The following indicators for surgical intervention are distinguished:
- Strictures of the pyelocaliceal part of the kidney, spermatic cord and ureter.
- Reducing the size of the bladder.
- Lack of effectiveness of drug treatment.
- Kidney dysfunction that only progresses.
With timely diagnosis and competent treatment, the prognosis can be favorable.
Manifestations of high detrusor activity
In women, acute urinary incontinence is a common pathology. Often, an overactive bladder causes associated problems, especially in elderly patients. The patient develops a psychoemotional disorder, sleep problems appear, and inflammatory processes worsen.
The main sign of bladder problems is a frequent urge to urinate, especially at night. In women, increased activity of the diseased organ is felt not only as constant discomfort, but often serves as an indirect cause of severe fractures during a fall.
The patient notes the appearance of frequent urination. A sudden urge is accompanied by continuous excretion of urine. The patient experiences a burning sensation throughout the entire urethra.
The patient is concerned about the following signs of pathology:
- spontaneous detrusor contractions;
- mild pain in the bladder when changing body position, sneezing, coughing.
Often the cause of the spastic state of the muscle layer of the diseased organ is a concomitant neurological illness. The appearance of severe symptoms is observed in patients with diabetes, and frequent urination in this category of patients leads to disability.
Anatomy of the male urethra
The structure of the urinary canal is different in men and women. This tube connecting the bladder and the urethral opening reaches plus or minus 20 centimeters in males.
For comparison: the female urethra is about 5 cm long. It is through this canal that a man exits urine and sperm.
The male urethra is an unpaired organ, consisting of posterior and anterior sections, which in turn are conventionally divided into three parts - prostatic, membranous and spongy.
It also has two S-shaped curves: subpubic and suprapubic.
The diameter of the channel is not the same throughout its entire length. With internal and external openings in the membranous part, the urethra narrows. In the prostatic part, in the bulb of the penis and at the external opening, it is, on the contrary, wider.
Inflammation as a cause of discomfort when urinating
Symptoms of cystitis in women are varied, associated with the appearance of inflammation in the walls of the detrusor and include:
- discomfort in the lower abdomen;
- weakness;
- headache;
- frequent urination;
- itching and burning during detrusor emptying.
In men, all the symptoms of cystitis are less pronounced; there is often no high fever and pain in the lower abdomen. If the disease is not treated, inflammatory damage to the pyelocaliceal system of the kidneys (pyelonephritis) quickly develops. The severe course of the disease in men is accompanied by reflex retention of urine and the appearance of severe abdominal pain.
Difficulty urinating often occurs in women after childbirth and is caused by poor circulation in the pelvic organs. On the first day, the woman in labor notices the absence of urge, which is caused by dysfunction of the nerves that penetrate the tissues of the bladder.
A large amount of accumulated urine leads to inflammation. Poorly performed catheter placement during labor may contribute to the development of bacterial infection. Strong urges usually do not correspond to the amount of urine released, and the unbearable desire to empty the detrusor causes the appearance of false urinary incontinence.
Diagnostics
Ignoring problems and symptoms leads in some cases to irreversible processes. As a result, it becomes completely impossible to regain lost health.
For early detection of diseases, women are recommended to undergo a full examination. Diagnostic methods include blood and urine tests, ultrasound, MRI, X-ray, cystoscopy, and RT.
If there is blood in the urine, poor laboratory results, or frequent pain syndromes, an ultrasound examination is prescribed.
It allows you to examine the organ, determine possible changes in size, and assess the level of functioning of the bladder. Using ultrasound, it is easier to diagnose tumors and also determine their location.
Ultrasound diagnostics
Before the ultrasound, a woman is strongly advised to drink plenty of fluids to fill her bladder.
Tomography is recommended only for those women whose exact diagnosis could not be established after ultrasound.
Cystoscopy
Before the tomography, you are prohibited from eating any food to ensure emptying of the intestines, and in the evening you are given an ampoule with a special contrast agent to drink.
In the morning, an enema is given, the urine is drained using a catheter, and the bladder is filled with oxygen.
Cystoscopy is performed using a special modern device - a cystoscope. The doctor can visually observe any abnormalities in the organ.
These may be inflammatory processes, violations of the integrity of the organ, tissue structure.
How does the disease manifest in older people?
With age, many problems arise regarding the functioning of the urinary organ. Stress urinary incontinence develops in women suffering from increased anxiety, suspiciousness, and experiencing significant physical exertion.
Bladder problems in women over 50 years of age are caused by high activity of the external detrusor sphincter. If the patient has not treated cystitis, she experiences involuntary urination. The patient complains of a feeling of incomplete emptying of the detrusor, copious urine output at night.
Problems often arise in older women after surgery on the pelvic organs. In this case, the muscles that support the urinary organ weaken, and urinary incontinence develops.
Pain in the detrusor region can persist for a long time. The acute form of urine retention causes the patient an unbearable desire to empty the bladder, but no urine is released. The chronic form of delayed urine output leads to detrusor emptying 1-2 times a day.
Factors provoking pathology
Problems with urination in men are caused by various reasons.
The development of a particular disease can lead to:
- unsafe sex;
- low physical activity;
- pelvic organ injuries;
- poor nutrition;
- drinking alcohol in large quantities;
- constant stress.
Poor urination does not always indicate the presence of pathology. Sometimes it is caused by taking drugs for potency, sexual disorders, and even hypochondria or hysteria.
Recent psychological problems can lead to difficulty emptying the bladder, even in a child.
Cancer and detrusor dysfunction
A malignant tumor of the bladder in older people causes problems with the urinary organ. Concomitant pathologies aggravate the course of the underlying disease:
- arterial hypertension;
- cardiosclerosis.
The patient complains of a strong urge to urinate, a scanty amount of urine, and discomfort in the back muscles resulting from the pressure of the tumor on the ureter. The manifestation of the pathology is pain that radiates to the perineum and is accompanied by involuntary release of urine. The patient also suffers from an unpleasant smell of urine.
Discomfort in the detrusor area increases if there is a bacterial infection or infiltration (germination) of the bladder wall with a tumor occurs. Increased blood clotting can also cause acute urine retention.
Often the patient develops anuria - a complete absence of urine. If the cancer has spread to nearby tissues, urine is released drop by drop.
Video about neurogenic bladder
A little about the functions of the bladder
The bladder is a muscular organ that temporarily stores urine. In women, it is located directly behind the uterus, and ligaments in the pelvis hold it securely in place. The size of the bladder varies depending on the amount of fluid it can hold. When it is empty, its diameter does not exceed 7.5 cm; when it is full, it can absorb up to 2 liters of urine.
Sphincters - the muscles surrounding the opening of the organ - are mobile. By closing tightly, they help keep urine from leaking into the urethra. The nerves in the walls of the bladder are very sensitive. They signal to you that it is time to go to the toilet and empty your bladder. During urination, the brain sends signals that relax the sphincter muscles and tighten the walls of the organ to squeeze fluid out.
When all the signals follow each other in the correct order, no unexpected troubles occur. And if some kind of failure occurs in the system, you are faced with the problem of urinary incontinence. Next, let's talk about the myths that accompany this medical condition.
Neurogenic dysfunction
When the functioning of the nervous system is disrupted or hormonal levels change in the body, significant dysfunction of the urinary organ occurs. In this case, the woman complains of frequent or rare urges, an increase in the amount of urine produced, and involuntary contraction of the detrusor wall.
After an injury that occurred in the lumbar spine, the patient experiences difficulty in excreting even a small amount of urine, and the sensitivity of the detrusor is completely lost. There is overstretching of its walls and expansion of the ureters.
Complications and consequences
If an active bladder is not treated promptly, unpleasant consequences and complications may occur. Among them, we note increased agitation, sleep disturbances, the appearance of depression, difficulty adapting to the work team, and the appearance of complications during pregnancy.
It is important to know that the disease develops much faster in children. If a woman is diagnosed with hyperactive urinary tract during pregnancy, then there is a possibility that a similar pathology will appear in the baby. Therefore, OAB must be treated.
