bladder dysfunction
Introduction
Introduction Urinary dysfunction caused by damage to the central or peripheral nerves that urinate. Mainly caused by trauma such as spinal cord injury and craniocerebral trauma; diseases of the nervous system such as hypertension, diabetes, syphilis, tremor palsy, poliomyelitis, multiple sclerosis, encephalitis, stroke, etc.; long-term or overdose of some drugs The effects of urinary central nervous system, such as blood pressure lowering drugs, digestive ulcer treatment drugs, desensitizing drugs and drugs on the central nervous system, can affect the central nervous system and vascular smooth muscle tissue caused by urinary dysfunction.
Cause
Cause
1. Trauma: It is the most common cause of neurogenic bladder. Among them, spinal cord injury and craniocerebral trauma.
2. Diseases affecting the nervous system: high blood pressure, diabetes, syphilis, tremor palsy, poliomyelitis, multiple sclerosis, encephalitis, stroke, etc., can cause vascular disease of the occlusive brain and spinal cord or directly cause brain And spinal cord injury, causing dysfunction of the cortex, brainstem and spinal urination center.
3. Drug effects: due to long-term or excessive taking of some drugs, affecting the central nervous system, such as blood pressure lowering drugs, digestive ulcer treatment drugs, desensitizing drugs and drugs acting on the central nervous system, can affect the central nervous system and vascular smooth muscle tissue Causes dysuria.
Examine
an examination
Related inspection
Reproductive system tumor examination item bladder ultrasound examination intravenous urography angiography
Diagnostic points for urinary tract infections:
1. Infants and young children common urine odor, frequent urination, urinary interruption or crying, nocturnal enuresis, intractable diaper rash, accompanied by fever, wilting.
2. Older children have frequent urination, difficulty urinating, abdominal pain or low back pain, fever, urine odor and nocturnal enuresis.
3. Chronic or repeated authors often have a course of >6 months, which may be associated with hypothermia, weight loss, anemia, and even hypertension or renal insufficiency.
4. Centrifugal leukocytosis 5 / HP, urinary leukocyte excretion rate of 200,000 ~ 400,000 / h is suspicious, 400,000 / h has diagnostic significance. Urine colony counts range from 10,000 to 100,000/ml, women are suspicious, men have diagnostic significance, and >100,000/ml can be diagnosed.
5. ACB, U2 m, urine lysozyme determination helps to distinguish upper and lower urinary tract infections.
6. X-ray and B-ultrasound are also helpful for diagnosis.
Diagnosis
Differential diagnosis
1. Detrusor hyperreflexia, patients often have frequent urination, urgency, urge incontinence and reflex urinary incontinence. It is characterized by intermittent involuntary urination, and the patient has no feeling at all when urinating. It can also cause urinary retention and filling urinary incontinence due to damage to the body's nerves, or upper motor neurons, and extra-urethral sphincter damage.
2. Detrusor no reflection, common symptoms are dysuria, sometimes urinary retention, filling urinary incontinence and stress urinary incontinence, urinary feelings such as significant loss or complete loss. Bladder volume and residual urine volume are generally greater than patients with detrusor hyperreflexia.
3. In addition to urinary symptoms, it can also be accompanied by constipation, fecal incontinence, perineal sensation loss or loss, limb paralysis and other neuropathy symptoms and signs.
Diagnostic points for urinary tract infections:
1. Infants and young children common urine odor, frequent urination, urinary interruption or crying, nocturnal enuresis, intractable diaper rash, accompanied by fever, wilting.
2. Older children have frequent urination, difficulty urinating, abdominal pain or low back pain, fever, urine odor and nocturnal enuresis.
3. Chronic or repeated authors often have a course of >6 months, which may be associated with hypothermia, weight loss, anemia, and even hypertension or renal insufficiency.
4. Centrifugal leukocytosis 5 / HP, urinary leukocyte excretion rate of 200,000 ~ 400,000 / h is suspicious, 400,000 / h has diagnostic significance. Urine colony counts range from 10,000 to 100,000/ml, women are suspicious, men have diagnostic significance, and >100,000/ml can be diagnosed.
5. ACB, U2 m, urine lysozyme determination helps to distinguish upper and lower urinary tract infections.
6. X-ray and B-ultrasound are also helpful for diagnosis.
