The residual volume of urine in the bladder is normal. Bladder and residual urine

Diseases of the genitourinary sphere 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 is not completely empty.

Normally, men may have a slight accumulation of urine (up to 50 ml). In the presence of pathological processes in the body, the volumes of unexposed fluid can be up to 1 liter. This phenomenon can entail serious complications (hydronephrosis, pyelonephritis). The first signs of urinary disorders require early diagnosis and adequate treatment.

Causes of incomplete bladder emptying

In men, this syndrome can be a signal for 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 in the area of \u200b\u200bits entry into the bladder.
Prostatitis - inflamed tissues of the prostate gland swell, the volume of intercellular fluid increases, the urethra is compressed.
Prostate tumor - can lead to the development of urinary retention only if the neoplasm grows into the urethra and reduces its diameter.
Injuries, surgical interventions in the bladder.
Neurogenic bladder.
Cystolithiasis - the presence of stones can cause obstruction of the ureters, stagnation of urine.

Additional causes of innervation may include:

spinal cord injuries;
endocrine disorders;
multiple sclerosis;
enterocolitis;
pathology of the peripheral nervous system.

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Characteristic signs and symptoms

In a healthy man, bladder emptying should be complete. The admissible norm of the residue is about 10% of urine, that is, for an adult it is not more than 50 ml. If its volume is higher than the permissible norm, it can be argued about the development of urological pathologies. To confirm or refute the diagnosis, you need to accurately establish the amount of urine residue.

There is a complete or incomplete urinary retention. With a complete delay, even with strong straining, a man can not excrete urine at all. A partial delay is the incomplete emptying of the bladder.

Additional signs indicating an increase in the amount of residual urine:

feeling of incomplete emptying after urination;
sluggish stream of urine;
strong straining when urinating;
pain during urination is possible.

With a gradual increase in residual urine and a prolonged obstruction to its outflow, chronic ischuria develops. With incomplete emptying, the disease can be asymptomatic for a long time. The patient can identify the problem only after complications due to stagnation of urine and impaired renal function.

A long delay in urine leads to stretching of the muscles of the bladder and sphincters. From a crowded organ, urine begins to stand out involuntarily. The paradoxical ischuria is developing. Constant urination in incomplete portions leads to the fact that an acute delay can not be recognized on time. The second stage of the disease develops, in which degenerative-dystrophic changes in the nerve receptors of the bladder occur.

In chronic residual urine, kidney function is almost always impaired. A man may be bothered by:

lumbar pain
fever, chills;
weakness;
loss of appetite.

Important! Due to stagnation of urine, a secondary infection may join and general intoxication of the body may develop. The manifestations of such symptoms require immediate medical attention.

Possible complications

If the man has an outflow of urine and he does not take any measures to eliminate the problem, ultimately this will lead to the development of dangerous pathologies:

chronic pyelonephritis;
cystolithiasis and nephrolithiasis;
urethritis;
hydronephrosis;
renal failure.

Diagnostics

It is impossible to independently determine the volume of residual urine. To do this, resort to research methods such as catheterization of the bladder and abdominal ultrasound.

Quite often, diagnosis gives false-positive results. The fact is that normally it is carried out within 5 minutes after urination. But, as a rule, more time passes between going to the toilet and conducting an examination and a new portion of urine has time to accumulate in the bladder.

The reception of diuretics, as well as the use on the eve of a large volume of fluid, can distort the diagnostic results. Some patients find it difficult to go to the toilet in the clinic due to certain psychological discomfort. To get more reliable results, the analysis must be carried out at least 3 times.

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

general analysis of urine, blood;
urine according to Zimnitsky;
blood biochemistry;
bacterial urine culture with an antibioticogram;
urography;
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, then normal urination can be restored only after eliminating its root cause:

conservatively or operatively to restore urinary tract patency;
stop the inflammatory process;
bring the contractile function of the body back to normal.

Etiotropic therapy

Her main task is to cure the disease, which led to residual urine. With atony of the bladder, drugs are prescribed that restore the ability to contract. For cramping, muscle relaxants are recommended. 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 of those that provoke spastic organ contraction.

If incomplete emptying in men is caused by cystitis, treatment should include the use of antibacterial drugs, which the doctor selects based on the type of pathogen. Antibiotics of the macrolide and fluoroquinolone group are effective. In addition, antispasmodics, diuretics, vitamins, immunomodulators, as well as diet food are prescribed.

With urolithiasis, treatment consists in the elimination of calculi. Depending on the types, sizes, shapes of stones, the doctor may prescribe conservative therapy using stone-dissolving drugs. But in most cases, surgical intervention is used, since drug therapy is ineffective in the presence of large formations and those that are not amenable to dissolution. An effective surgical method of treatment is lithotripsy (crushing stones using ultrasound or a laser). The operation is less traumatic, not violating the integrity of the patient's skin. Recovery after crushing pass quickly enough, without serious consequences.

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

Catheterization

With the accumulation of a large amount of fluid in the bladder and the impossibility of its natural emptying, you have to resort to the method of catheterization - the introduction of a rubber catheter into the urethra. The procedure is performed by a doctor in a hospital. Self-administration of a catheter at home is prohibited - high risk of infection of the bladder.

First, the urethral opening is treated with a disinfectant. The catheter is moistened with glycerol and inserted into the urethra with tweezers. Movement should be done progressively, gradually advancing 2 cm. You cannot force the catheter forward. In some diseases (for example, urolithiasis), such a procedure can entail serious consequences.

Sometimes it may be necessary to establish a permanent catheter. It should be in the urethra for several days. To prevent infection, you should flush the bladder with antiseptic agents (Furadonin, Nitroxolin). An oral antibiotic may be prescribed. If catheterization is not possible, the patient is referred to a urologist, where the question of the possibility of surgical intervention to resolve the cause of urinary retention will be resolved.

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

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Symptoms

Chronic urinary retention provokes impaired renal function - this is easy to detect thanks to isotopic renography. As a result, pyelonephritis, diverticulum, urolithiasis, cystitis, or any other disease develop. If a person has chills, fever and severe back pain, then doctors may suspect urosepsis. In the body, it can occur in a malignant form, as evidenced by toxic changes in the blood - high leukocytosis, for example.

Most common causes

Some more factors ...

Varieties of urinary retention

Other forms

How to help the patient?

Treatment

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The amount of urine that remains in the human body after urination is called residual urine. Regardless of age, this is considered a deviation. Urine retention can be complete and incomplete. In the first case, the patient feels the urge to the toilet, but cannot do this. Sometimes for several years, emptying occurs only with a catheter. With an incomplete delay, urination occurs, but not completely. Residual urine in the bladder often provokes stone formation and inflammation. Lack of treatment is unacceptable. Indeed, each time the disease progresses, the level of residual urine is constantly growing, the bladder begins to stretch, pain appears, and in the end - urinary incontinence.

The rate of residual urine in the bladder: in men, in women, in children

The norm of residual urine for men and women is 30-40 ml. The critical figure is 50 ml. This means that a person has a normal outflow of urine, and the development of diseases occurs. As for the norms of residual urine for the child, they are as follows:

in newborns 2-3 ml;
in babies up to a year of 3-5 ml;
in children 1-4 years old, this norm is 7-10 ml;
4-10 years - 7-10 ml;
10-14 years - 20 ml;
for adolescents under the age of 14, the norm is not more than 40 ml.

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Reasons for the increase

Residual urine can occur due to a large number of reasons. In general, they are divided into three groups:

obstructive;
inflammatory and infectious;
neurological.

Uterine fibroids and ovarian cysts in women can prevent urine from leaving the body.

Health problems that prevent urine from leaving the body are considered obstructive. For example, stones, tumors, polyps, prostate adenoma in men, uterine fibroids and ovarian cysts in women, as well as narrowing and soldering of the urinary canals. Edema of the urethra and contraction of the muscles of the bladder, which arise due to inflammatory-infectious diseases, also lead to a delay in urine. So, the prostate, cystitis, urethritis provoke the appearance of residual urine.

The last group of reasons includes the loss of control of urination by the central nervous system. In such cases, the bladder itself is healthy, and the problem lies in the muscles of the organ or sphincter, which stop contracting at the right time. The causes of this state of the body are often sclerosis, injuries to the spinal cord and brain, congenital pathologies of the central nervous system, and also spinal diseases. The fact is that antidepressants, antiarrhythmic, diuretic, hormonal drugs, drugs for Parkinson's disease, as well as some painkillers negatively affect the tone of the body.

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Symptoms of residual urine after urination

When you leave the toilet, but you have the feeling that there is still remnants of urine inside - the first alarm bell and a symptom of a bladder disease. Also, the symptoms include an unstable or intermittent stream of urine or when it drops out at all. In addition, the presence of a symptom such as a continuous urination process after muscle tension in the abdominal wall also determines health problems.

Doctors associate other symptoms with diseases that provoke the appearance of final urine. So urolithiasis is characterized by frequent urination, pain in the bladder area, and the appearance of blood in urine. As well as urinating, patients experience itching and burning. Usually the pain becomes stronger after exercise or hard work.

With the prostate, men suffer from groin pain and sexual dysfunction. And pyelonephritis leads to lower back pain, a sharp increase in body temperature to 37.5–38 degrees, and there is also a feeling of general fatigue. Cystitis also causes frequent urination, sharp pains in the lower abdomen. During urination, itching and burning occur. And also over a long period of time, the temperature rises to 37.1−38 degrees.

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Diagnosis: how to determine the amount of residual urine?

This deviation is dangerous because at the first stage of development it does not have pronounced symptoms. This contributes to the progression of the disease and it goes into a more severe stage. In the second stage, the manifestations are already more pronounced. But even now they can be confused with the common cold, as this is chills, fever, lower back pain. Therefore, it is very important to determine the residual volume of urine. If it exceeds the norm, then this is the first symptom of illness.

Urinalysis in combination with other diagnostic methods will help determine the pathology.

Determination of residual urine is a rather complicated process and consists of a set of measures:

laboratory diagnostics;
urological research;
neurological research.

So, first of all, in order to determine the volume of residual urine (OOM), you need to conduct clinical blood tests, urine and analysis for bacteriological culture of urine. The next step is an ultrasound of the bladder, prostate, uterus and ovaries. In addition, if necessary, the patient has to undergo cystoscopy and an urodynamic study. Cystoscopy is considered the most effective, but it is also known for its harm. Therefore, doctors only in extreme cases prescribe this procedure.

Also, the determination of OOM is carried out using ultrasound. It is carried out twice. The first time with a full bladder, and then 5-10 minutes after urination. The amount of fluid is determined by a special formula. The height, width and length of the bubble are taken into account. In order for the OOM result to be accurate, the procedure is carried out 3 times.

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Errors in Results

Unfortunately, there is a big risk that the results of analyzes to determine the residual volume of urine may be erroneous. Therefore, if you have a positive diagnosis, do not worry and repeat all the procedures. So, before undergoing an ultrasound, you need to refrain from diuretic drinks, drugs, as well as those products that irritate the bubble. After all, 10 minutes after their use, the amount of urine increases by 100 ml, and, of course, the result will be distorted. In addition, all tests should be carried out immediately after the patient went to the toilet. Only under these conditions will the OOM be measured correctly. Of course, in most cases it is impossible to have an ultrasound immediately after emptying.

And also, in order to completely free your bladder from urine, urination must be done in the usual conditions, and in the hospital this is simply impossible. Also, the patient should go out of need in connection with a natural urge, and not because it is necessary. The posture also matters, it should be familiar. If you do not follow these rules, then, of course, the diagnosis will reveal the remainder of the urine.

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Complications

At the first signs of the disease, you should immediately consult a doctor.

If you suspect that there is excess urine in the body, then seek qualified help immediately. After all, the consequences of your delay can cause you many problems. Very often, doctors have to operate on patients, because treatment with drugs is not able to help. And all this only because of the belated determination of the final urine. Therefore, among the complications, the most common are:

inflammation of the kidneys and urethra;
renal failure;
stones in the kidneys;
hydronephrosis.

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Disease treatment

Residual urine in the body is not a disease; it only indicates its presence. That is why, first of all, it is necessary to determine the causes of the appearance of an excess of urine. In addition, you need:

restore patency of the urinary canals;
relieve inflammatory processes;
to restore the ability of the bubble to contract.

The basic principles of treatment:

it must beat complex;
the treatment process should not be interrupted in any case;
the doctor should choose a course with minimal side effects.

Neurological abnormalities are considered much more complex. In this case, unfortunately, you can not do without surgical and medical intervention. If the patient has atony, the doctor prescribes medications that will help the bladder restore the function of contraction. With its cramps, muscle relaxants are often prescribed. If all attempts turned out to be futile, then you have to perform an operation, during which the doctor dissects those nerves in the spinal cord that form spastic contractions of the bladder.

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When a symptom appears that is full of the bladder, after urination, we do not always consult a doctor immediately. But incomplete emptying of the bladder in men can have various causes, as a rule, indicating a violation of the genitourinary functions. However, it is not immediately possible to make a correct diagnosis. You will have to undergo some examination and take tests, after which the doctor will make a diagnosis.

Incomplete emptying of the bladder in men occurs when:

Narrowing of the urethra due to inflammation (urethritis);
The bladder works with pathological dysfunction;
In the area of \u200b\u200bthe bladder there is inflammation (cystitis);
There is inflammation of the prostate;
There are inflammatory processes in the kidneys (pyelonephritis);
Malignant and benign neoplasms;
Urolithiasis disease.

Also, the cause of incomplete emptying of the bladder can be various injuries, residual effects or complications after a previous illness, as well as an incorrectly performed surgical operation.

To identify the cause, it is necessary to carry out the following diagnostic procedures:

You may also need to undergo an additional examination:

Tissue biopsy;
Tomography of internal organs;
Cystoscopy of the bladder cavity;
X-ray urography.

Ultrasound is by far the most accurate method for diagnosing diseases, which makes it possible to accurately determine not only the disease of the bladder, but also closely located organs associated with it.

Biopsy and tomography are additional studies that help to see the detailed condition of the tissues of the internal organs.

Cystoscopy, determines the condition of the inner surface of the bladder, namely the mucous membrane.

Symptoms of a disease in which the bladder does not empty completely can be as follows:

Heaviness in the lower abdomen;
Both difficulty urinating and urinary incontinence;
The appearance of bloody inclusions in the urine (hematuria);
Colic in the renal region if urolithiasis occurs;
Acute pain during physical exertion, when lifting weights, pressing on the stomach;
Acute pain, sometimes cutting, in the presence of an infection of the genitourinary organs;
An increase in temperature, a deterioration in the physical condition of the body.

Incomplete emptying of the bladder in men is fraught with the development of bacterial inflammation inside the bladder and urethral canal, which can subsequently move to the kidneys, leading to pyelonephritis.

What treatment is indicated if you have a full bladder sensation?

Depending on the diagnosis, the doctor selects various treatment methods.

With inflammation of the prostate gland, drug treatment is performed. The treatment program includes taking antibiotics selected by your doctor. Anti-inflammatory drugs are prescribed to reduce pain. As a result of treatment, the size of the gland decreases and urination is facilitated.

Many bacteria tend to quickly develop resistance to antibiotics, so it is extremely dangerous to self-medicate. The entire treatment period should be under the supervision of a doctor. Also, in order to increase the body's resistance, the intake of vitamins can be prescribed in the complex of therapy.

With prostate adenoma, medication may not bring the proper result. Then the doctor prescribes surgical treatment.

Recently, innovative minimally invasive treatment methods (laparoscopy, endoscopy) are most often used.

If the disease is old, accompanied by rapid rapid development, acquired neglected forms over time, then antibiotics will most likely not have any effect on it. Will have to undergo surgical treatment.

If residual urine in the bladder in men occurs due to inflammation of the urethra, the doctor prescribes treatment with antibiotics, anti-inflammatory drugs and immunomodulators.

With a diagnosis of urethral stricture, most likely, surgical intervention is indispensable. The operation is aimed at expanding a narrow section of the urethra.

If the sensation of incomplete emptying is posed with cystitis, urolithiasis and neoplasms of various etiologies, first I begin therapeutic treatment. If the selected treatment methods do not show positive dynamics, the doctor may prescribe the only effective surgical method.

In extremely severe cases, when the patient cannot independently empty the bladder, they resort to emergency excretion of stagnant urine.

Prescribe injections to reduce pain, as well as injections aimed at relieving acute inflammation. They also resort to urine excretion using a catheter.

In mild cases of the disease, alternative methods of treatment can also be used.

With cystitis, you can use decoctions of herbs:

1 tbsp. spoon of horsetail, 1 tbsp. a spoon of potentilla and 1.5 tbsp. a spoonful of plantain leaves pour one liter of boiling water. Insist 1 hour, wrapping a towel. Then strain through a sieve and take 1 cup 2 times a day, morning and evening. Take until relief comes.
You can also use a decoction of lingonberry leaves, brewing 4 tbsp. tablespoons of one liter of boiling water. Boil for 15 minutes over low heat, then the broth should be infused for 4 hours. Take 150ml 3 times a day. The broth well removes inflammation and has a diuretic effect.

With prostate adenoma, decoctions of herbs can be used:

Take 1 tbsp. spoon celandine, pour 1 tbsp. boiling water. Insist for two hours, strain and drink 1 tbsp. spoon half an hour before meals 3 times a day. Treatment is carried out for one month, not only to relieve symptoms, but also to prevent relapse of the disease.

The feeling of a full bladder can be caused by neurological diseases and age-related changes. In both cases, as a rule, there are pathologies of the brain and spinal cord, congenital disorders, as well as neoplasms.

To apply this or that treatment method, you must consult a doctor who, after finding out the true causes of the disease, will prescribe an adequate treatment. Self-medication can not only aggravate the course of the disease, but also lead to the development of serious diseases.

Materials:

In the urologist's office, there are frequent cases when patients complain that the urine does not completely exit the bladder. Moreover, both women and men can suffer from such a nuisance. Doctors call this phenomenon residual urine - the fluid that remains in the body, despite the efforts of a person to completely empty. At the same time, 50 ml is already considered a significant volume, although in especially severe cases the “unnecessary weight” reaches the limit of several liters.

It is not surprising that the main complaint of people with such a disorder indicates incomplete emptying of the bladder. There may be several reasons for concern: a weak “signal” to go to the toilet, a process that stretches over several stages, as well as muscle tension and the application of effort to ensure that the desired act takes place. In this case, patients may not feel any other discomfort. But doctors are sure that even these seemingly minor problems should be an occasion for a visit to the clinic. After all, they lead to a number of serious and serious complications.

Based on the above facts, we can make an absolutely logical conclusion: urine does not completely exit the bladder when the body "eats" the disease - chronic or acute. There are many factors leading to the problem:

Mechanical causes are diseases of the genitourinary system and kidney infections. For example, trauma to these organs, the presence of tumor formations on them, as well as prostate cancer, adenoma, phimosis, and the presence of stones.
Diseases of the nervous system: injuries to the spinal cord or brain, tumors, myelitis, and so on.
Drug intoxication. It is diagnosed when the patient has been taking narcotic drugs or sleeping pills for a long time.

The most common cause of urinary retention in men is adenoma. The problem arises when the blood rushes strongly to this organ. The acute form is caused by severe hypothermia, alcohol abuse, a sedentary lifestyle and digestive tract disorders.

Some more factors.

But this is not all the reasons that people complain about, noticing in themselves the residual urine and pain when the bladder is empty. It happens that the problem arises against a background of a fracture of the pelvic bones and an urethral injury - in most cases among the stronger sex. Less commonly, such discomfort is a consequence of a disorder of the nervous regulation of the muscular membrane of the bladder or the defective work of the sphincters of this organ. Hemorrhages in the spinal cord, compression of the vertebrae, etc. can lead to it.

Acute urinary retention often has a reflex character. That is, it is observed in a person in the first few days after he underwent surgery on the pelvic organs or suffered from the influence of severe stress. Sometimes the disease is diagnosed in completely healthy people who regularly drink alcohol. Alcoholics develop atony of the cystic muscle - a weakening of the walls of the bladder, as a result of which the patient cannot fully control the act of emptying.

Varieties of urinary retention

This disorder can be of two types. When urine does not completely exit the bladder, doctors diagnose a complete or incomplete delay. The first involves the patient's desire to go to the toilet, in which the body can not even allocate a drop of liquid. Such people have been releasing urine from an organ artificially for years - through a catheter. With a partial liquid exit, they say that the act began, but for some reason it was not completed until the end. Usually, a nuisance occurs against the background of the above diseases. Once the problem is fixed, the process will recover. If you do not take the necessary measures on time, the delay may become chronic.

Frequent emptying of the bladder without its complete emptying leads to stretching of the walls of the organ. This, in turn, provokes the appearance of another nuisance - the inability to retain fluid in the middle of the body. At first, a person loses a few drops, after some time he is not able to completely control the process - urination occurs anywhere under different conditions. Such a phenomenon is called paradoxical ishuria.

Other forms

A disorder called residual urine is sometimes associated with rather unusual factors. For example, there is a peculiar form of delay, which is characterized by a sudden interruption of the process with the ability to continue it. The patient begins to empty normally, but the act suddenly stops. Often the cause is a stone located in the ureter. When the body position changes, manipulation resumes. Doctors say that some patients with urolithiasis can only go to the toilet in one pose - sitting, squatting, sideways.

Delayed emptying may be accompanied by hematuria - the presence of blood in the liquid. Sometimes it can be seen with the naked eye: urine acquires a pinkish or brown hue. If the presence of blood is too small to notice, the liquid is taken for analysis, where it is analyzed and drawn conclusions under a microscope. By the way, experienced urologists can detect urinary retention even with a routine examination. In such patients, a swelling provoked by the presence of an incompletely empty bladder is felt in the lower abdomen.

How to help the patient?

If the urine does not completely exit the bladder, a person needs urgent medical advice. An acute form of organ dysfunction requires emergency assistance. Typically, a catheter is inserted into these people for normal emptying. For this purpose, the outer opening of the channel is treated and disinfected, after which a rubber tube gently dipped in generously moistened with petroleum jelly or glycerin is carefully introduced into it. The tweezers regulate the movement of the catheter, fixing it in the urethra. The procedure is carried out progressively - 2 centimeters, without rush and sudden movements.

If the cause of the problem in the patient is urolithiasis or prostatitis, then the manipulation is not carried out. In these cases, the presence of a rubber tube in the organ can lead to serious complications. A catheter can be placed on an ongoing basis. In this case, the procedure is performed by a urologist, prescribing antibiotics after it in order to avoid the development of inflammatory processes. The patient himself can insert a temporary rubber tube directly to himself before the act of emptying. But before that, he should consult a doctor.

Treatment

The feeling of incomplete emptying of the bladder is rather unpleasant. To get rid of him forever, you must first remove the cause that caused the problem. Have a full examination by a qualified urologist. Having consulted with a nephrologist, gynecologist and oncologist if necessary, he will diagnose the disease and take measures for its treatment. Oddly enough, the hardest thing to heal reflex delays, as they are psychological in nature. Here, sessions of psychotherapy help, as well as such simple manipulations as irrigating the genitals with warm water or the operation of a water tap during urination.

Remember that incomplete emptying can be a concern throughout life. In this case, they talk about relapse. Moreover, it occurs in cases where the patient picks up an infection of the urinary tract. Therefore, it is so important to take care of your health and to sound the alarm at the slightest manifestations of discomfort. Self-medication is extremely dangerous and often leads to serious consequences and serious complications.

Materials

Residual urine is the remaining fluid in the bladder that remains after the act of urination has been completed. Such symptoms are most alarming in pediatric urology. Such a phenomenon is considered to be an equally serious pathology in adulthood. There is a certain norm of residual urine, if a person is diagnosed with a limit value or it exceeds the permissible norm, doctors consider the suspicion of the presence of any disease of a urological nature.

Often this phenomenon is observed in childhood. Key reasons for it are often hidden behind such dysfunctions in the activity of the bladder:

The lack of contractile activity of the walls of the body, as a result of this, the full expulsion of fluid does not occur.
Malfunctions in the functioning of the sphincter, the result of which is stagnation of urine in the bladder.

For medical examinations, the phenomenon of residual urine plays an important role. This is due to the fact that in the event of stagnation of urine in the body over a long period of time, a person's health can rapidly deteriorate. Incontinence is often accompanied by symptoms such as:

Frequent urge to go to the toilet.
Insufficient amount of fluid.
Infectious processes in the bladder.

Such an indicator is of great importance in clinical studies, since it entails a decrease in the quality of the function of the upper urinary canals or may cause signs of dysfunction in the emptying of the bladder. Residual urine is often one of the clinical signs of various pathologies of the genitourinary system, for example, vesicoureteral reflux, bladder diverticulitis.

Norm and complication

Normally, a person’s bladder should be completely empty during an act of urination. The permissible deviation rate is not more than 10% of the total urine residue, depending on the age norm of a person, for example, in childhood, the allowable urine residue rate is not more than 5 ml of urine, for an adult this figure is up to 50 ml. If this indicator exceeds the permissible deviations, this may indicate that infectious or inflammatory reactions in the genitourinary system develop in the body. To confirm this assumption, a residual urine test is given. At the time of the analysis, it is important to properly collect the fluid.

With stagnant processes in humans, the pressure of the internal organ rises. This entails a deterioration in the well-being of a person, kidney function may be impaired. Pathogenic microorganisms develop in stagnant urine, the infection spreads, and calculi form in the kidneys.

How to determine?

To clarify this indicator should use medical diagnostic methods. Self-determination of the level of residual urine is not possible. The most common research methods are bladder catheterization and abdominal ultrasound.

The simplest and most accurate method of determination is the insertion of a catheter. This method is used for adults. To determine the indicator in childhood, ultrasound is used. The specialist during it takes measurements of the width, height and length of the bladder.

Erroneous results

In determining such an indicator, false-positive results often occur. This is due to improper fluid intake. The best option is to collect urine before visiting a doctor’s office. But often, between the intake of fluid and a visit to the diagnostic room, a certain time period passes, during which the next portion of urine in the body can accumulate in the person, you need to go to the toilet again.

A factor such as the use of diuretic drugs or the intake of a large amount of fluid per day before the test can also negatively affect the results. So, if a patient drinks a diuretic drug before being examined, urine begins to accumulate quickly in his body, its amount is about 10 ml per minute.

Often, a person cannot take an analysis in a hospital, as he feels discomfort in such conditions, so an analysis may show an excess of residual urine.

This will make it possible to correctly determine the indicator and make an accurate diagnosis.

Effects

If a person suffers from dysfunction in urination, but does not visit a doctor, ignoring this problem, various pathological processes often develop in his body.

Stagnation in the bladder can cause various inflammatory and infectious processes of a urological nature, such as:

The appearance of chronic pyelonephritis.
The formation of calculi in the kidneys, such a disease can be cured only with the help of surgical intervention.
Urethritis.
Hydronephrosis.
Dysfunctions in the work of the kidneys.
Renal failure.

With timely medical attention, it is possible to eliminate the problem of congestion in the body by taking medications. If the disease is at an advanced stage, a person will need treatment in a hospital. To fully recover, resort to surgical treatment.

Therapeutic therapy

In advanced situations, therapeutic measures include the introduction of a rubber catheter and the removal of excess urine from the bladder artificially. Such therapy is possible only in a hospital setting, self-medication is unacceptable. At home, it is not possible to place the catheter correctly in the urethra.

Such a device is administered for 2-3 days, it must be constantly treated with various antibacterial agents (Nitroxoline, Furadonin).

Treatment at home consists in treating the external genitalia with heated water, this stimulates urination and the removal of excess urine. If this method is ineffective, Novocaine or another drug that is prescribed by the doctor is injected into the urethra. It is not recommended to insert a catheter at home, this can lead to infection of the organ and the development of additional inflammatory processes and infections.

Timely seeking medical help is important. This will make it possible to carry out less painful treatment, prevent pathological and inflammatory processes in the kidneys.

Residual urine is an important criterion for determining the presence of pathological changes in the lower urinary tract. In a healthy body in the bladder cavity after the act of urination, the remainder of the urine should not exceed 10% of the total volume of urine. Determining the amount of residual urine in the bladder is of great diagnostic importance in a number of pathologies, usually requiring immediate treatment.

Urination mechanism

The act of urination (innervation) is the totality of the work of the muscle layer (detrusor) of the bladder, which, by contracting, ensures the removal of fluid and the sphincters of the urethra, which regulate the retention of urine during its accumulation until the moment of desire to perform the act of urination.

Depending on the development of pathological changes in any of the structural elements of the urinary tract responsible for the removal of urine, various types of disorders occur, leading to damage to the detrusor of the bladder with the subsequent development of atrophy and, accordingly, the inability to adequately contract.

Important! Despite the fact that the amount of urine in excess of 50 ml is of clinical importance, the maximum residual amount can exceed 1 liter.

Table: Permissible residual urine volume by age

Causes

All the causes of the appearance of residual urine can be divided into several groups:

neurological in nature;
inflammatory and infectious;
obstructive;
independent pathologies (diverticulum, urethral stricture).

Neurological disorders

Neurological disorders are always associated with disruption of the part of the nervous system that is responsible for the three functions of the bladder:

reservoir (a function that ensures the accumulation of urine in the cavity of the bladder);
evacuation (function that helps to remove urine);
valve (a function that allows you to hold a certain amount of urine in the bladder).

The defeat of any level of the nervous system - from the nerve endings located on the inner surface of the bladder, and ending with disorders in the brain, can lead to a number of deviations, including hyperfunction of the urethral sphincter. As a rule, the cause of the development of this pathology is spinal cord injury due to:

tumor formations;
intervertebral hernia;
spinal injuries;
congenital CNS pathology (observed, as a rule, in a child).

Due to the difficulties encountered during urination, even with a full bladder, an atony of the muscle layer develops, which under constant pressure loses the ability to contract and expel fluid, accumulating a large volume of residual urine.

Treatment of a neurogenic bladder consists of psychological, physical and medical methods of exposure:

correction of behavioral lifestyle (streamline drinking and urination);
stimulation of urination by massaging the back;
physiotherapy;
drug effect on weakening the tone of the sphincter;
drugs that regulate the central nervous system;
physiotherapy.

Plexus of nerve endings in the lumbosacral region stimulates the process of urination

Inflammatory processes

As a rule, the role of inflammatory diseases in the formation of residual urine is the formation of urethral edema or sphincter spasm, due to soreness and irritation of tissues. A similar reaction can be observed with cystitis, balanitis and urethritis. A separate place among the inflammatory diseases that form a persistent violation of urination is inflammation of the prostate in men.

An enlargement of the prostate gland due to an inflammatory process or the formation of a benign (prostatic hyperplasia) or malignant (prostate cancer) neoplasm causes, at the initial stages of the development of the disease, minor urination disorders, which subsequently lead to more pronounced:

increased urge to the toilet;
intermittent flow during urination;
the need for tension of the press and straining to completely empty the bladder cavity;
feeling of incomplete emptying of the bladder.

Important! With timely access to a doctor, prostate adenoma is successfully treated with the combined effects of medications and physiotherapeutic procedures, and allows you to return to normal life.

An enlargement of the prostate gland towards the bladder creates an obstacle to the outflow of urine

Urinary tract obstruction

The presence of stones in the bladder is one of the most common causes of residual urine formation. Cystoliasis with the same frequency occurs in both men and women. Only the mechanism of calculus formation is different - the formation of calculi directly in the cavity of the bladder is characteristic of the male body, and the migration of kidney stones by the female body.

The reasons for the formation of stones can be internal or external factors of influence:

chronic infectious diseases of the urinary tract;
violation of metabolic processes;
improper diet;
sedentary lifestyle;
work in hazardous industries;
wrong drinking regimen.

In addition to the main signs of the formation of residual urine, with cystoliasis there is pain in the lower abdomen with irradiation in the groin, scrotum or perineum. Also a characteristic feature is a sharp interruption of a full jet during urination. Treatment consists in removing stones with medication or lithotripsy, followed by their elimination in a natural way.

Important! Therapy with stone-destroying drugs helps to dissolve calculi in the kidneys and bladder within 2-6 months, but it has many side effects.

The drug Kanefron prevents the formation of calculi and has a minimum of contraindications

Diverticulum

A diverticulum is a saccular cavity formed from the wall of the bladder. There are two types of diverticula - true and false. A true diverticulum consists of the mucous and muscle layer of the bladder tissue and, as a rule, is a congenital anomaly.

False diverticulum (acquired) develops as a result of an increase in intravesical pressure that occurs against the background of pathological conditions, accompanied by difficulties in urination and systematic incomplete emptying of the bladder. Due to high fluid pressure, atrophy of the muscle layer develops, the destroyed fibers diverge, and the mucous membrane undergoes pressure in the abdominal cavity.

The main difference between a false diverticulum and a true one is the absence of muscle fibers in the structure of its wall. The main clinical sign of a diverticulum is double urination with the appearance of turbid urine.

Treatment consists, first of all, in eliminating the causes of increased intravesical pressure (in case the diverticulum is acquired) and subsequent surgical removal of the deformity.

Urethral stricture

A pathological narrowing of the patency of the urethra is called urethral stricture. Metaplasia of the tissues of the urethral mucosa can be caused by various causes of damage of varying severity:

thermal or chemical burns of the urethra;
inflammatory processes (cystitis, urethritis);
perineal injuries or bruises;
mucosal injury during catheter placement;
congenital abnormalities of the urinary tract.

Due to the replacement of damaged cells with mucous membrane by connective tissue, scar formation occurs, which significantly complicates the process of urination, as a result of which urine remains in the bladder.

X-ray urethral stricture

Signs and Complications

Urine, which remains after urination in the cavity of the bladder, not only delivers a large number of unpleasant sensations, but is itself an alarming symptom, the severity of which directly depends on its quantity.

Residual urine is an important clinical sign, as it leads to impaired function of the upper urinary tract and is a consequence of pathological processes leading to functional disorders of the bladder.

The main symptoms accompanying the excess of residual urine are:

increased urge to urinate;
weak or intermittent stream;
the need to strain the abdominal muscles in order to start the process of urination or to prevent its interruption;
inflammatory processes in the urinary tract.

In the absence of timely treatment, the risk of developing inflammatory processes increases, since stagnation creates a favorable environment for the development of pathogenic microflora and the formation of stones. Violation of the outflow of urine can also lead to the development of hydronephrosis, pyelonephritis and renal failure.

In the treatment of acute urinary retention, it is removed with a rubber catheter.

Diagnostics

Determining the presence and amount of residual urine is the main purpose of the examination, which includes questioning the patient for the presence of clinically significant symptoms. The following are instrumental research methods, which include:

study of the dynamics of changes in the pressure of the jet during urination (urofluometry);
an orthostatic urine sample;
measurement of pressure in the bladder at different moments of urination (cystometry);
assessment of the contractility of the muscle layer of the walls of the bladder (electromyography);
study of the functional state of sphincters and urethra (urethroprofilometry);
Ultrasound of the bladder before and after urination;
Ultrasound of the prostate gland.

Laboratory research methods:

clinical analysis of urine (determining the presence of bacteria, proteins and nitrogen in the urine);
clinical blood test;
determination of prostatic specific antigen (PSA).

A reliable method for determining the amount of urine residue is the direct catheterization method. But due to the difficulties associated with its implementation (invasiveness, risk of damage to the urethra, provocation of inflammatory processes), the assessment of the amount of residual urine is mainly carried out using ultrasound.

The diagnostic technique consists of two stages:

Ultrasound of a filled bladder.
An ultrasound performed 10 minutes after urination.

At the same time, the dimensions of the three-dimensional image of the bladder and the length of its ultrasound shadow are estimated using mathematical formulas.

Important! In case of suspected prostate hyperplasia in men, the most informative diagnostic method is transrectal ultrasound.

Technique of transrectal ultrasound

Since residual urine is just a symptom, restoration of the bladder detrusor function consists in treating the underlying disease and regular removal of urine using stimulating methods (washing with warm water, massage of the sacral spine, and the use of antispasmodics).

A positive effect can be achieved by applying methods that improve blood circulation in the pelvic organs (aerobic exercise, walking, breathing exercises), relieve inflammation, and reduce the amount of fluid used in sleep. The vast majority, with timely treatment to the doctor, the muscle wall tone can be restored without the use of surgical treatment methods.

More abnormalities are found in older people. This is due to a weakened tone of the MP. An insufficient reduction of the walls leads to the fact that the body cannot push out the urine in full.
Also, this symptom may appear due to the action of the following factors:

The presence of infection (cystitis, prostatitis, urethritis, etc.);
Anatomical pathologies (as for the male body - prostate adenoma, prostatitis; female - cysts, ureterocele, urethral adhesions, etc.);
Taking medications whose side effect is a weakening of the tone of the MP (diuretic, hormonal, etc. drugs);
Nervous overstrain, which leads to a weakening of the central nervous system control over the process of urination.

If urine is not excreted for a long time, then the patient will soon feel a deterioration in well-being:

The feeling of incomplete emptying of the MP;
Discomfort during sexual intercourse;
Urinary incontinence.

Stagnation of urine leads to increased pressure in the MP. Ignoring this problem over time leads to all sorts of complications:

MP infection;
The appearance of inflammatory processes in the organs of the urinary system;
Impaired renal function, pyelonephritis, stone formation, renal failure.

Stagnant urine is a favorable environment for the propagation of pathogenic bacteria, which can lead to the development of bullous cystitis, therefore, symptoms of pathology cannot be ignored, it is necessary to consult specialists in time.

After urination, residual urine in a small amount remains in the bladder. Normally, in adult women and men, its amount does not exceed 30 - 40 ml.

Bladder pathology

In children, this value is 3-4 ml. If its volume exceeds 50 ml, then this indicates a violation of the normal outflow of urine through the urethra.

Increased urine

Violation of the innervation of the urinary tract can develop in several ways. Residual urine appears in large quantities with reduced contractility of the musculature of the wall of the bladder (detrusor).

In this case, it is not reduced enough to “push” the entire volume of urine. In some cases, sphincters of the urethra are not functioning properly.

Then urination stops due to premature closure of the urethral sphincter.

Failure in the nervous regulation of the urination process can occur with a back injury with damage to the spinal cord, general diseases of the nervous system (Parkinson's or Alzheimer's disease, etc.), impaired blood circulation in the pelvic organs.

The structure and mechanism of the bladder

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

Causes

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

A common female problem is cystitis. The disease has an infectious status and is associated with a female anatomical structure. With inflammation of the mucosa, a symptom such as incomplete emptying of the bladder in women appears. Difficulties in urinating in men are associated with inflammatory processes and changes in the prostate or kidney.

Often this phenomenon is observed in childhood. Key reasons for it are often hidden behind such dysfunctions in the activity of the bladder:

The lack of contractile activity of the walls of the body, as a result of this, the full expulsion of fluid does not occur.
Malfunctions in the functioning of the sphincter, the result of which is urinary stasis in the bladder.

Frequent urge to go to the toilet.
Insufficient amount of fluid.
Infectious processes in the bladder.

This symptom may occur due to various pretexts, and some of them are not even related to pathologies of the genitourinary system. Conventionally, they can be divided into several categories.

Residual urine rates in women, men and children

There is an acceptable rate of residual urine. If the volume of urine that remains in the MP after urination does not exceed 10% of the total volume before emptying, then this is a normal phenomenon that does not require medical intervention.

In women, men, or a child, the urine residue in the bladder after emptying is significantly different. The acceptable value for women and men is not more than 50 ml. For children, the normal balance depends on the age group:

Newborns - up to 3 ml;
Children under 1 year - up to 3-5 ml;
Up to 4 years - 5-7 ml;
Up to 10 years - 8-10 ml;
Under 14 years old - 11-20 ml;
Adolescents 14-18 years old - up to 40 ml.

At the initial stages, exceeding the norm is usually not manifested by severe symptoms. The patient does not feel pain or significant discomfort. Just the process of emptying the MP occurs a little more often and shorter than usual.

In a healthy man, bladder emptying should be complete. The admissible norm of the residue is about 10% of urine, that is, for an adult it is not more than 50 ml. If its volume is higher than the permissible norm, it can be argued about the development of urological pathologies. To confirm or refute the diagnosis, you need to accurately establish the amount of urine residue.

There is a complete or incomplete urinary retention. With a complete delay, even with strong straining, a man can not excrete urine at all. A partial delay is the incomplete emptying of the bladder.

Additional signs indicating an increase in the amount of residual urine:

feeling of incomplete emptying after urination;
sluggish stream of urine;
strong straining when urinating;
pain during urination is possible.

Characteristic signs and symptoms

Residual urine is just one of the various symptoms that are found when the urinary tract becomes clogged and inflammation. But if its appearance is associated with neurological disorders, then such a problem is much harder to detect, in particular, if it is a small child.

If before that you felt like a healthy person, then the first sign of urinary retention will be the presence of lethargic urges to empty. This symptom has a gradual development, as does organ atony. You can feel it on several grounds.

If you have a diverticulum, then there will be no pressure and pain, but urination will occur "in two steps." First, a large portion will come out, and then scanty. Such a process comes from the fact that at first the bladder itself is emptied, and after the diverticulum appears there.

Diagnostics

To confirm or refute the diagnosis, you need to accurately measure the volume of residual urine. At home, an accurate study will not work, so you need to resort to medical diagnostics.

Analyzes.

First, the doctor must collect an anamnesis, palpate the MP region and prescribe general blood and urine tests to the patient.

The method that determines the volume of residual urine in the MP is abdominal ultrasound.

But more often an x-ray with a contrast agent is carried out. In order for the data obtained to be reliable, it is necessary that the study be carried out with a full bladder and 5-10 minutes after it is empty. Before the diagnosis, the patient must observe several conditions:

Do not take diuretic drugs and significantly exceed the amount of fluid consumed;
Before the diagnosis, there should be no long delay in urination, otherwise the organ walls will stretch and after the first emptying, the results may turn out to be unreliable.

In practice, not all conditions are always met, which can cause a false-positive result, so studies are often carried out several times.

Also, a catheterization method of MP is used for diagnosis.

Which is more suitable for adult patients. This method allows you to more accurately determine how much urine remains in the MP after emptying, but has the drawback - the need to use a catheter, which can damage the MP or urethra.

In the early stages of the formation of an increased volume of residual urine, the pathology is easily corrected with the help of drug therapy, but in advanced cases, a more radical method is often used - surgical intervention (MP cystostomy), so you need to monitor your health and seek medical help on time.

This process consists of several neurological, urological, laboratory tests and surveys. The first time you visit a urologist, you will be assigned the following procedures.

Ultrasound of the bladder and pelvic organs. Such a study is carried out in two phases. The first is when the bladder is full to measure its volume and size. The second ultrasound scan is 5-10 minutes after its emptying. For the result to be accurate, the calculations are carried out at least three times. There are special formulas for calculating the amount of fluid for which the following parameters are needed:

height;
width;
the length of the ultrasound shadow of the bubble.

If the patient is taking diuretics at the moment, or before the examination he drank drinks or ate foods that could irritate the organ for examination, then it is necessary to warn the doctor about this, as the diagnosis may turn out to be erroneous due to these influencing factors.

Ultrasound is considered a non-invasive method, since the rate of residual urine in men and women is not accurately determined. But it is used more often because of its general availability.

Clinical analysis of blood and urine, urine culture, determination of bacterial infection.

Cystoscopy and contrast urography are necessary. The first type of examination is prescribed in the most extreme case, since it is quite traumatic. But it accurately indicates the volume of residual urine, if any.

Do not forget that the calculation of the volume and analysis of urine with prostatitis and other diseases in which this symptom appears may be erroneous in ultrasound and other examinations due to nervous strain.

It is impossible to independently determine the volume of residual urine. To do this, resort to research methods such as catheterization of the bladder and abdominal ultrasound.

Cystitis treatment

Residual urine is not a separate disease, but only one of its symptoms. In order to have a bowel movement, it is necessary to eliminate the factor that violates it. The following measures may be taken.

Removal of the inflammatory process.
Restoration of patency of the urinary tract. An operational or conservative method may be chosen.
Normalization of the contractile capabilities of the bladder.

For neurological disorders, more difficult therapy will be required. Here it is possible to use both surgical and medical methods.

If you have found atony of the bladder, then the doctor will prescribe drugs that restore the skill of contraction. With spasm of the body, muscle relaxants are prescribed. If they do not help, then a surgical procedure called "selective dorsal rhizotomy" is performed. During this, the doctor makes a selection in the bundle of nerves of the spinal cord - only those that are responsible for spastic contraction of the bladder, and makes them dissect.

The main thing is compliance with complex therapy, which will act not only on the symptoms, but also on their causes.

If you identify this symptomatology, be sure to consult a doctor, because only he can correctly diagnose the problem and prescribe the appropriate treatment.

If residual urine in a man has been identified, treatment should be prescribed immediately. Therapy should be aimed at eliminating the cause of the appearance of residual urine. In addition, there are basic principles of treatment:

Treatment should be comprehensive and act on all parts of the disease development system;
Continuity of treatment;
Treatment should be with minimal side effects.

One of the first symptoms of bladder cancer is the presence of residual urine. For the treatment of malignant neoplasms of this localization, several methods are used:

Surgery. Transurethral resection is a modern method of treating tumors. This method is indicated for tumors of small size and without germination in the muscle layer. Otherwise, a bladder resection or partial cystectomy is performed. In the later stages, complete removal of the bladder is performed.
Immunotherapy. In this case, BCG vaccine is introduced into the tumor, which significantly slows down its growth and development. Such treatment is contraindicated in patients who have tuberculosis of any localization.
Radiation therapy. Interstitial irradiation is carried out together with the external.
Chemotherapy. It consists in the introduction of doxirubicin or etoglucide into the bladder.

These methods will help eliminate the accumulation of residual urine in the bladder.

For the treatment of prostate adenoma, it is advisable to use hormonal drugs that reduce its size, as well as herbal preparations. If ineffective, surgical treatment is performed:

Transurethral removal of the prostate gland;
Prostatectomy with open access.

In addition, cryodestruction, the use of high temperatures or exposure to the prostate with laser radiation have a positive result. To reduce the volume of residual urine, balloon dilatation of the urethra is also used so that the urine can flow out freely.

Given that cystitis is an infectious pathology, treatment should be aimed at eliminating the pathogen. To do this, apply:

Broad-spectrum antibiotics;
After seeding and determining the sensitivity of microorganisms, the most effective antibacterial drug is prescribed;
In the case of cystitis caused by viruses - antiviral drugs are prescribed;
Nonsteroidal anti-inflammatory drugs to lower fever and pain;
Antispasmodics that help relax the tense wall of the bladder.

It is also necessary to strengthen immunity with the help of immunomodulators, vitamins and hardening of the body.

Stones in the bladder irritate its wall. As a result, the contractile function is impaired, and the bladder is emptied with the formation of residual urine.

For the treatment of this disease, there are conservative and surgical methods. With small sizes of stones, a diet is prescribed depending on the composition of the stone, as well as medications.

However, their effectiveness is low and they act only on stones consisting of urates. To reduce pain and spasms caused by damage to the bladder wall with a stone, analgin and no-shpu are used.

The stones are quickly removed using a cystoscope that crushes the stones. This type of operation helps to avoid bladder injuries. If this method does not give a result, the operation is performed with open access and opening the bladder.

In addition to surgery, there are non-invasive treatments. Remote lithotripsy helps to destroy stones with the help of electromagnetic waves. However, this method is not effective in all cases and is not prescribed for large stones.

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, then normal urination can be restored only after eliminating its root cause:

conservatively or operatively to restore urinary tract patency;
stop the inflammatory process;
bring the contractile function of the body back to normal.

Etiotropic therapy

Her main task is to cure the disease, which led to residual urine. With atony of the bladder, drugs are prescribed that restore the ability to contract. For cramping, muscle relaxants are recommended. 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 of those that provoke spastic organ contraction.

With urolithiasis, treatment consists in the elimination of calculi. Depending on the types, sizes, shapes of stones, the doctor may prescribe conservative therapy using stone-dissolving drugs.

But in most cases, surgical intervention is used, since drug therapy is ineffective in the presence of large formations and those that are not amenable to dissolution. An effective surgical method of treatment is lithotripsy (crushing stones using ultrasound or a laser).

The operation is less traumatic, not violating the integrity of the patient's skin. Recovery after crushing pass quickly enough, without serious consequences.

Catheterization

With the accumulation of a large amount of fluid in the bladder and the impossibility of its natural emptying, you have to resort to the method of catheterization - the introduction of a rubber catheter into the urethra. The procedure is performed by a doctor in a hospital. Self-administration of a catheter at home is prohibited - there is a high risk of infection of the bladder.

Therapeutic therapy

Such a device is administered for 2-3 days, it must be constantly treated with various antibacterial agents (Nitroxoline, Furadonin).

Timely seeking medical help is important. This will make it possible to carry out less painful treatment, prevent pathological and inflammatory processes in the kidneys.

Possible complications

If a person suffers from dysfunction in urination, but does not visit a doctor, ignoring this problem, various pathological processes often develop in his body.

Stagnation in the bladder can cause various inflammatory and infectious processes of a urological nature, such as:

The appearance of chronic pyelonephritis.
The formation of calculi in the kidneys, such a disease can be cured only with the help of surgical intervention.
Urethritis.
Hydronephrosis.
Dysfunctions in the work of the kidneys.
Renal failure.

The bladder is designed so that with normal urination, it does not empty completely. It contains residual urine in a small amount. The norm for each is different, depending on age. In adults, this is not more than 50 ml, in children - 10% of the total volume that fits into the organ.

If the size of the residual urine exceeds the normal volume, then this is a clinical sign of a disease. After all, this means that urination is impaired, and this is only possible with some painful processes. If this urological symptom manifests itself in children, then this is a very alarming sign, which signals that a full examination is necessary.

Moreover, stagnant urine is quite painful, and if no measures are taken, then the symptoms and volume will increase every day, provoking bacterial inflammation, urinary incontinence and the formation of stones.

Causes

This symptom may occur due to various pretexts, and some of them are not even related to pathologies of the genitourinary system. Conventionally, they can be divided into several categories.

Inflammatory and infectious. Due to such diseases, there is swelling of the urethra, and there may also be a symptom of spastic compression of the muscle tissue of an organ, since its irritation of a reflex nature occurs. Residual urine in men indicates the presence of such diseases of this gender:

prostatitis;
urethritis;
balanitis;
cystitis.

Obstructive. These are cases when mechanical barriers appear that squeeze outflow of urine from the outside or inside. It could be:

male prostate adenoma;
uterine fibroids, female ovarian cysts;
the formation of adhesions, narrowing of the urethra and stones;
the appearance of tumors.

Medication. Also, the tone of the body can weaken from the action of certain drugs. It can be:

muscle relaxants;
diuretics;
antidepressants;
hormonal;
drug-based painkillers;
medicines for the treatment of Parkinson's disease.

when congenital defects of the central nervous system are present (in particular in children);
in the presence of diseases of the spine;
with injuries to the brain and spinal cord;
if there is multiple sclerosis.

Symptoms

If you have a diverticulum, then there will be no pressure and pain, but urination will occur "in two steps." First, a large portion will come out, and then scanty. Such a process comes from the fact that at first the bladder itself is emptied, and after the diverticulum appears there.

Diagnostics

This process consists of several neurological, urological, laboratory tests and surveys. The first time you visit a urologist, you will be assigned the following procedures.

Ultrasound of the bladder and pelvic organs. Such a study is carried out in two phases. The first is when the bladder is full to measure its volume and size. The second ultrasound scan is 5-10 minutes after its emptying. For the result to be accurate, the calculations are carried out at least three times. There are special formulas for calculating the amount of fluid for which the following parameters are needed:

height;
width;
the length of the ultrasound shadow of the bubble.

If the patient is taking diuretics at the moment, or before the examination he drank drinks or ate foods that could irritate the organ for examination, then it is necessary to warn the doctor about this, as the diagnosis may turn out to be erroneous due to these influencing factors.

Ultrasound is considered a non-invasive method, since the rate of residual urine in men and women is not accurately determined. But it is used more often because of its general availability.

Clinical analysis of blood and urine, urine culture, determination of bacterial infection.

Cystoscopy and contrast urography are necessary. The first type of examination is prescribed in the most extreme case, since it is quite traumatic. But it accurately indicates the volume of residual urine, if any.

Emergency organ emptying

If a lot of fluid has accumulated in this organ, and the patient does not have the ability to withdraw it naturally, then catheterization is required.

This procedure may be contraindicated for some patients, for example, if a spasm of the urethral sphincter is detected, in which case botulinum toxin is injected into this area so that the muscle tissue relaxes.

In some situations, they can install a urethral stent with a short period of operation - from 3 to 6 months. It looks like a cylinder made of a thin wire spiral, 1.1 mm in diameter. In the manufacture of used absorbable organic material, which soon disappears.

Treatment

Removal of the inflammatory process.
Restoration of patency of the urinary tract. An operational or conservative method may be chosen.
Normalization of the contractile capabilities of the bladder.

For neurological disorders, more difficult therapy will be required. Here it is possible to use both surgical and medical methods.

The main thing is compliance with complex therapy, which will act not only on the symptoms, but also on their causes.

If you identify this symptomatology, be sure to consult a doctor, because only he can correctly diagnose the problem and prescribe the appropriate treatment.

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The norms of residual urine in the bladder in men, women and children

Due to the fact that the structure and size of the organs of each person is different and depends on the physique and heredity, the indicators will be individual and may vary. The rate of residual urine in men and women varies between 40-45 ml. In children, this volume changes and grows with age. In a child immediately after birth, residual urine is found to be less than 3 ml. In one-year-old children, the volume of urine after release from urine is up to 5 ml. In children at the age of 4, the bladder contains up to 7 ml of urine after visiting the toilet. In 10-year-old children, the amount of residual urine is up to 10 ml. With age, the bladder grows, and the volume of urine after urination increases and reaches a volume of 20 ml at the age of 15 years.

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Causes of increased urine residue in the urea

Problems with a neurological urea can be due to vertebral hernias.

Neurological disorders occur with spinal injuries, tumors, hernia of the spine. In adolescents, neurological disorders include congenital abnormalities in the central nervous system. Inflammatory processes of an infectious nature push the body to pathological changes in the genitourinary system if a person has cystitis, balanitis or urethritis.

male inflammation in the prostate leads to the fact that the remainder of the urine is not removed from the urea. With inflammation, patients complain of frequent urges to empty the bladder, a weak stream of urine, the impossibility of urination without the application of effort. In this case, the patient is haunted by the feeling that the urea is not completely empty. Urolithiasis refers to obstructive causes of stagnation of urine. In the male half, stones form in the urine, and in women, they descend from the kidneys.

Diverticulum and stricture of the urethra are pathologies caused by the presence of other, aggravating the situation, diseases.

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Symptoms of Deviation

Symptoms of the fact that the rest of the urine in the bladder has ceased to fall within the normal range are extensive and unpleasant. The very fact that a large volume of residual urine accumulates in the bladder indicates the passage of abnormal processes in the body. To this is added the fact that the accumulation of urine causes pathologies and disturbances in the functioning of the organs of the genitourinary system. The amount of urine remaining after urination helps to determine the severity of deviations. The main symptom of the disease is a feeling of incomplete emptying of the bladder. The remaining manifestations are associated with additional disorders and manifest themselves in the form of:

An additional symptom of mote pathology is a jump in temperature.

frequent desire to go to the toilet;
unstable and meager urine flow;
excessive efforts during the urination process;
the presence of blood in the urine;
pain syndrome during physical exertion;
temperature spikes.

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What is the pathology dangerous?

If the first symptom occurs, you should seek help from a doctor and undergo a diagnosis. If you ignore and start the disease, urinary stagnation will occur in the bladder and the pathogenic flora will begin to multiply in it. This will lead to the onset of an infectious and inflammatory process. Additionally, with stagnation of urine, the chance of calculus formation increases. Due to increased pressure, residual urine rises to the kidneys and provokes:

hydronephrosis;
pyelonephritis;
renal failure.

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How to determine the presence of pathology?

The purpose of diagnosis is to correctly determine the residual urine. For this patient, they are questioned about the manifestations that he had to face. Then he is prescribed a general analysis of urine and blood and a specific analysis to determine the presence of adenoma and prostate cancer. Instrumental research methods include procedures:

Diagnose the disease using cystometry.

uroflowmetry;
an orthostatic urine sample;
cystometry;
electromyography;
urethroprofilometry;
Ultrasound of the urea;
Ultrasound of the prostate.

To determine the residual volume of urine (OOM), an ultrasound examination is performed in 2 stages. To begin with, a diagnosis is made with a full bladder. Then they ask the patient to empty the urea and sit for 15 minutes, and then again examine the changed organ on the monitor of the device. The difference in size and volume visible by ultrasound is calculated according to normative tables.

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Disease treatment

The choice of treatment method determines the disease due to which urine remains in the urine. If the treatment passes correctly and the patient manages to achieve positive results, the residual urine in the bladder in men and women will cease to reach critical volumes and will return to normal. It is possible to eliminate the root cause that caused the deviation by using the following methods:

conservative or surgical intervention to restore the patency of the urinary canals;
relief of inflammation;
recovery of the contractile muscles of the urinary system.

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Etiotropic therapy

For the treatment of cystitis, immunostimulants are prescribed.

The treatment method includes many different approaches, used depending on the specific pathology that caused the accumulation of residual urine. If diagnosed with urea atony, medications are used to help restore the contractility of the organ. In the presence of spasms in the bladder, muscle relaxants are prescribed to the patient. If it was not possible to achieve a positive result, the doctor decides on the operation to dissect certain nerve fibers in the spinal cord responsible for spasm of the urea. With cystitis, the course of therapy is supplemented with antibacterial drugs, individually selected. The course of treatment is supplemented by the use of antispasmodics, diuretics, vitamin complexes, immunostimulants and compliance with the diet prescribed by the doctor. With stones in the urea or kidney, therapy consists in removing calculi with:

stone-removing drugs that dissolve and remove small calculi;
surgery using ultrasound equipment, crushing stones of any size.

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Catheterization

If too much residual urine accumulates, then the patient is given catheterization of the urea.

To carry out the catheterization procedure, the patient is asked to lie in a hospital. This procedure is necessary in a situation where residual urine accumulates in large volumes, and independent emptying of the urea is completely difficult. The method consists in placing a rubber catheter in the urethra and bladder, with which the patient will empty the accumulated urine. The procedure for the introduction of a catheter cannot be carried out independently because of the high probability of injuring the internal organs of the genitourinary system and causing infection. In the hospital, before the introduction of the catheter, the urethra is disinfected. The catheter itself will be wetted in glycerin and gently inserted into the urethra with tweezers. If you need a permanent catheter, it is left for several days, but preventive rinsing of the urea with the help of the antiseptics "Furadonin", "Nitroxoline" is carried out. Sometimes an antibacterial agent is prescribed for internal administration.