frequent urination
Introduction
Introduction Normal adults urinate 4 to 6 times during the day and 0 to 2 times during the night. Frequent urination is a symptom, not a disease. Due to a variety of reasons, the number of urination can be increased, but there is no pain, also known as urination frequency. There are many reasons for frequent urination, including neuropsychiatric factors, physical weakness after illness, and parasitic diseases. For children with frequent urination, it is necessary to exclude urinary tract infection, vulva or local inflammation of the penis. Chinese medicine believes that the frequency of urination is mainly due to the weakness of the child's constitution, the kidney is not solid, the bladder is incompetent, and it is not declared. In addition, too tired, the spleen and lungs are both dirty, the upper imaginary can not be made, the soil can not produce water, the bladder is weak, and the frequency of urination occurs. Therefore, frequent urination is a deficiency, need to nurse, eat more foods rich in plant organic active alkali, eat less meat, eat more vegetables.
Cause
Cause
(1) Increased urine output: When the amount of urine increases, the number of urination will increase accordingly. Under physiological conditions, such as drinking plenty of water, eating watermelon, drinking beer, due to the increase in water intake, through the regulation and filtration of the kidneys, the amount of urine increases, the number of urination increases, and frequent urination occurs. In pathological conditions, such as partial diabetes, diabetes insipidus patients drink more water, more urine, and more urination. However, there is no feeling of urination discomfort.
(2) Inflammatory stimuli: When there is inflammation in the bladder, the neurological threshold is lowered, the urinary center is in an excited state, and frequent urination occurs, and the amount of urine is reduced (adults <300-500 ml/time). Therefore, frequent urination is an important symptom of cystitis, especially acute cystitis and tuberculous cystitis. Others, such as prostatitis, urethritis, pyelonephritis, pediatric chronic penile head dermatitis, vulvitis, etc. can appear frequent urination. Under the stimulation of inflammation, frequent urination, urgency, and dysuria occur simultaneously, which is called urinary tract irritation, commonly known as "three urine signs."
(3) Non-inflammatory stimuli: such as urinary tract stones and foreign bodies, usually with frequent urination.
(4) reduction of bladder capacity: such as bladder occupying lesions, increased uterine compression during pregnancy, tuberculous bladder contracture or larger bladder stones.
(5) Psychotic urinary frequency: Frequent urination is only seen in white sputum, or before going to sleep at night, often mentally nervous or seen in patients with rickets. At this time, it may be accompanied by urgency and dysuria.
Examine
an examination
Related inspection
Semen acidity prostate tumor marker (PSA) prostate specific acid phosphatase prostate specific antigen acid phosphatase
1. History: focus on the marital status of bladder irritation, pregnancy history, childbirth history, urinary dysfunction, gross hematuria, fever, low back pain, gynecology, pelvic disease history.
2. Physical examination: should pay attention to kidney tenderness, snoring pain on the ureter, lumbar rib point tenderness, bladder urinary retention, lower abdomen tenderness. Children pay attention to intestinal flatulence and diarrhea.
3. Laboratory examination: routine examination of hematuria, urine routine examination of pyuria, bacteriuria is a characteristic of urine culture is a must-check item, suspected L strain infection should be high-permeability culture. Immune function tests should be performed when suspected immune dysfunction, and renal function tests should focus on renal tubular function tests.
4. Cystoscopy: for the determination of interstitial cystitis bladder stones, tumors, urethral stricture hydronephrosis help. Prostate anal examination should be performed when suspected of enlarged prostate or cancer.
5. X-ray examination: It is helpful for the diagnosis of kidney size urinary system tumors, stones and urinary tract malformations. CT and MRI examinations are performed when necessary.
6. Ultrasound examination: The size of the kidney is measured for hydronephrosis, and urinary calculi and prostatic hypertrophy are helpful.
7. Urodynamic examination: It helps the urinary tract stenosis and obstruction.
Diagnosis
Differential diagnosis
Differential diagnosis:
Cystitis
Its clinical features are: frequent urination, urinary urgency and pain, but the signs of systemic infection are mild, because the bladder itself has no absorption function. Inflammation of the bladder triangle is prone to gross hematuria. Laboratory tests are characterized by normal renal function tests for pyuria.
2. Pyelonephritis
The symptoms of bladder dissipating are lighter than cystitis or no symptoms of bladder irritation; the symptoms of systemic infection are mild, high fever, nausea and vomiting, lack of appetite, body aches, kidney pain, etc. Physical examination can cause tenderness and snoring in the kidney. There is tenderness (where the ribs are at the intersection of the midline of the clavicle) and ureteral tenderness (outer rectus and umbilical level), middle and ureteral tenderness (the intersection of the trabecular line and the vertical line of the pubic tubercle). Laboratory tests in addition to pyuria urinary peripheral blood leukocytes increased, Zhongsheng granulocytes increased. Acute pyelonephritis may have a transient renal tubular dysfunction generally 1-3 months of recovery, chronic pyelonephritis can cause permanent renal tubular dysfunction, and even glomerular function is also impaired.
3. kidney tuberculosis
In the early stage, only the kidneys of the kidneys were involved. The ureter and bladder urethra are involved, so it is called urinary system tuberculosis. Urinary system tuberculosis is a tuberculosis lesion that can be found in addition to the secondary urinary system, especially active disease changes. The bed is characterized by long-lasting stimuli and general antibiotic treatment. Physical examination of the abdomen can touch the swollen kidneys, urine examination is a rice soup mixed with a large number of pus cells under the blood. Red blood cells can have varying degrees of proteinuria and urine is acidic. Acid-fast bacilli can be found in the urine to confirm the diagnosis. Late fibrotic epilepsy can form renal calcification, and the renal pelvis often has water.
