Drip after urination
Introduction
Introduction Post-urinary drip is not like normal urination. Generally, the prostatic hypertrophy has this kind of symptoms. When it starts to urinate, it begins to flow out little by little, and there is urine, which means that the urine is not smooth.
Cause
Cause
Prostatic hypertrophy is a degenerative disease. Generally, when the adult male is 30-40 years old, the prostate begins to have different degrees of hyperplasia, and symptoms appear after 50 years of age. Sex hormone levels decline, neuroendocrine disorders and dietary factors are the causes of the disease, it is a urinary tract obstruction caused by mechanical factors. Prostatic hypertrophy can cause temporary hypersexuality. After the age of 55, men almost have different degrees of prostatic hypertrophy. At the beginning of prostatic hypertrophy, patients may have increased sexual desire that is not consistent with age, or consistent sexual desire is normal, but suddenly becomes intense stand up. This is due to prostatic hyperplasia, which causes prostate dysfunction, and feedback causes testicular function to be temporarily enhanced. Sexual life will aggravate prostatic hypertrophy, and sexual life itself will cause the prostate to be in a state of hyperemia for a long time, causing and aggravating prostatic hypertrophy.
Examine
an examination
Related inspection
Urine routine urethral function test
Prostatic hypertrophy, if it develops around the urethra, may have only mild or no symptoms. If you develop to the bladder neck, even if the proliferation is not large, serious symptoms will occur. Patients generally show an increase in the number of urinations at an early stage, which is more pronounced at night. Every time urinating is often not clean, leaving residual urine, for a long time, can lead to bladder neck congestion and edema. As time goes by, the bladder muscles are fatigued, the urination is more weak, and the residual urine is increased. At this time, the prostate is more congested and edema, and the discharged urine line is slender and bifurcated.
Sometimes the urine is not in line, dripping out, sometimes the urine line is divided into two strands, and it takes half a minute to one minute to go to the toilet to get out. In the later stage, if the amount of residual urine is equal to the normal bladder capacity, the urine will automatically overflow when the sound of running water is heard or reflected by other stimuli. Extremely edematous congestion at the exit of the bladder neck. First, it is stimulated, such as cold, urinary, overworked, etc., and acute obstruction occurs, completely losing the ability to automatically urinate, called "acute urine retention."
When there is acute urinary retention:
1 hot compress the vaginal bladder area or perineum, or if the patient feels urinable during hot water bath, it should be tested in water, do not lose the opportunity to urinate.
2 From the navel to the midpoint of the pubic symphysis, gently massage, gradually add pressure, and sometimes the urine can be discharged.
3 acupuncture treatment often results in rapid results, acupuncture is generally the first to take Guanyuan, Zhongji, Yinlingquan, with acupoints for Sanyinjiao, Qihai.
4 catheterization if necessary.
The clinical manifestations of prostatic hypertrophy, as described above, the symptoms of anterior gland hypertrophy, mainly symptoms of dysuria, its performance:
1. Frequent urinary urgency: In the early stage of the disease, the number of urine is often increased, especially the increase in the number of urine at night causes the patient to pay attention. It is caused by a decrease in bladder capacity due to congestion and edema of the bladder neck and residual urine. When there is inflammation or accompanied by stones, there is urinary urgency.
2. Difficulties in urination: characterized by slow urinary tract, urinary weakness, urinary tract dripping, wet trousers and shoes, so that the patient is inconvenient to urinate and take the sputum, and then urinating in sections, that is, when venting with force, it can barely discharge A little pause, the urine flow is interrupted.
3. Urinary incontinence: The amount of residual urine is increasing. When there is a large amount of residual urine, there is often filling incontinence (pseudo-urinary incontinence), often with urine droplets, which makes the patient's pants often wet, which is very painful.
4. Acute urinary retention: On the basis of the urinary dysfunction mentioned above, acute urinary retention may occur at any time, so that the patient can completely urinate, and the pain is difficult to be jealous, forcing the patient to come to the hospital for emergency treatment. The causes of acute urinary retention are often climate change, cold, fatigue, and drinking. Therefore, although this disease has no seasonal factors, but the occurrence of urinary retention makes the patient have to come to the emergency department, often in the autumn and winter cool season. All of the above are symptoms of urinary dysfunction, in addition to urine changes and combined symptoms such as:
5. Hematuria: gross hematuria This disease is not common. In a few cases, due to bladder neck obstruction, venous return obstruction, varicose veins in the bladder, and even the formation of "bladder spasm", sometimes the blood vessels rupture and produce a lot of bleeding. In combination with stone formation or tumorigenesis, gross hematuria is also inevitable.
6. Complications caused by frequent urination: such as sputum, sputum, rectal prolapse, varicose veins of the lower extremities, emphysema, etc., can be found.
7. Late symptoms: due to kidney function loss, azotemia caused by failure, acidosis, high blood pressure, poor appetite, anemia, weight loss, heart failure, cerebrovascular disease symptoms, etc., are all visible.
8. Check and find
(1) Patients are all older men, generally over 50 years old.
(2) The swollen bladder can be found in the lower abdomen when the body is examined.
(3) When the anal finger is examined, the prostate may be swollen and the central groove disappears or the sides are widened. On the upper edge of the hypertrophic gland, the bladder that is swollen is often touched.
(4) It is still possible to find signs of complications such as sputum, sputum and rectal prolapse.
diagnosis
Prostatic hyperplasia is also called benign prostatic hyperplasia. Medically, benign prostatic hyperplasia is divided into histological prostatic hyperplasia and clinical prostatic hyperplasia. The former is through autopsy, and it is found that there is an obvious increase in prostate volume, or microscopic benign prostatic hyperplasia under the microscope, but clinically there may be symptoms or no symptoms.
The latter can be determined by the following three:
1 prostate symptoms (frequent urination, nocturia, urinary drops, urination, etc.).
2 Prostate volume increased (prostate volume > 20 ml).
3 indication of bladder outlet obstruction (maximum urinary flow rate.
For histologically, prostatic hyperplasia, from a global perspective, the incidence of each country is roughly the same, and there is a clear relationship with age, that is, the age increases and the incidence increases. According to foreign autopsy reports, prostate hyperplasia is 10% at the age of 35, and will increase with age by 85%.
Diagnostic examination of prostatic hypertrophy:
1, physical examination: check whether the patient's response is slow, with or without anemia, with or without edema. Hypertension (a clue to identify or exclude early uremia); whether there is a mass or position in the abdomen (determination of urinary tract obstruction or decompensation); whether there is secretion in the urethra, whether the epididymis is swollen (to determine whether there is Combined infection).
2, anal finger examination: check anal sphincter tension (distinguish between the neurogenic bladder) and prostate, pay attention to the size of the prostate, whether the central groove disappears, with or without nodules, prostate hardness, with or without tenderness.
3, laboratory examination: urine routine attention to the presence or absence of combined urinary tract infection; blood routine and biochemical examination: hemoglobin decreased, elevated urea nitrogen prompted uremia.
Diagnosis
Differential diagnosis
Poor urination: The main cause of poor urination is due to obstruction on the urinary tract or lack of contraction of the bladder. Under normal circumstances, there is urine in the bladder, which will be smoothly discharged through the bladder "opening" and urethra, but some people are very uncomfortable in urinating, not very laborious when urinating, or the flow is very fine when urinating, shot The urinary tract is also very close. Some people can't discharge it even if they are in the urinal for a long time. In severe cases, they can not develop urine. A large amount of urine "hoards" in the bladder and becomes urinary retention. The patient is very painful. Obviously, it causes urination. The main reason for the poorness is due to obstruction on the urinary tract or lack of contraction of the bladder.
Foreign body sensation of urination: It is because a patient with urinary calculi feels a foreign body sensation when urinating. Urinary calculi are rare in clinical practice. Most are derived from the urinary system above the bladder and bladder, such as kidney stones, ureteral stones or bladder stones. Stones can stay in the urethra or invade the urethra, scaphoid or urethra of the prostate when discharged. A small number of secondary to urethral stricture, urethral atresia, foreign body or urethral diverticulum. Stones that originate in the urethra are quite rare. Usually a single stone. Most of the stones in the combined infection are ammonium magnesium phosphate. Most female urethra stones occur in the urethral fistula.
Fine or interrupted urinary flow: acute prostatitis urinary tract symptoms: burning pain during urination, urgency, frequent urination, urine drip and purulent urethral secretions. Bladder neck edema can cause poor urination, fine or interrupted urinary flow, and severe urinary retention. The urinary flow is fluctuating: most patients with abdominal aortic aneurysm have no symptoms, and most of them are called a quiet abdominal aortic aneurysm when doing routine physical examination. With the development of regular physical examinations, it has been found that this type of aneurysm is also gradually increasing in symptomatic patients. The common symptoms are abdominal pulsating masses, followed by dull pain in the umbilical or upper abdomen or only abdominal discomfort. When the aneurysm invades the lumbar vertebrae, there may be pain in the lumbosacral region. Sometimes the aneurysm may enlarge or even penetrate into the duodenum or jejunum, thereby producing gastrointestinal bleeding. In addition, the enlargement of the tumor may produce some compression symptoms such as compression of the gallbladder. The general canal has jaundice; oppression of the duodenum causes intestinal obstruction; compression of the ureter causes renal colic or hematuria; when the bladder is compressed, there may be frequent urination and fluctuations in urine flow.
Interrupted urine flow: refers to the sudden interruption of urine flow during urination, sometimes accompanied by severe pain in the head of the penis. The most common cause is that patients with benign prostatic hyperplasia must increase their abdominal muscles to drain their urine. In the late stage of the disease, the urine can not be drained at one time, and it takes a breath to continue to urinate, which is manifested as interruption of the urine flow.
Prostatic hypertrophy, if it develops around the urethra, may have only mild or no symptoms. If you develop to the bladder neck, even if the proliferation is not large, serious symptoms will occur. Patients generally show an increase in the number of urinations at an early stage, which is more pronounced at night. Every time urinating is often not clean, leaving residual urine, for a long time, can lead to bladder neck congestion and edema. As time goes by, the bladder muscles are fatigued, the urination is more weak, and the residual urine is increased. At this time, the prostate is more congested and edema, and the discharged urine line is slender and bifurcated.
Sometimes the urine is not in line, dripping out, sometimes the urine line is divided into two strands, and it takes half a minute to one minute to go to the toilet to get out. In the later stage, if the amount of residual urine is equal to the normal bladder capacity, the urine will automatically overflow when the sound of running water is heard or reflected by other stimuli. Extremely edematous congestion at the exit of the bladder neck. First, it is stimulated, such as cold, urinary, overworked, etc., and acute obstruction occurs, completely losing the ability to automatically urinate, called "acute urine retention."
When there is acute urinary retention:
1 hot compress the vaginal bladder area or perineum, or if the patient feels urinable during the hot water bath, it should be tested in the water, do not lose the opportunity to urinate;
2 from the umbilical cord to the midpoint of the pubic symphysis, gently massage, gradually increase the pressure, and sometimes the urine can be discharged;
3 acupuncture treatment often results in rapid results, acupuncture is generally the first to take Guanyuan, Zhongji, Yinlingquan, with acupoints for Sanyinjiao, Qihai;
4 catheterization if necessary.
