Urinary incontinence in men. What types of this disease is and how is it treated? Deciphering the indicators of a general urine test

Urinary incontinence in men is a condition in which involuntary urination occurs periodically (incontinence).

The likelihood of this disease increases with age, but there is no direct relationship. Urinary incontinence in men, as a rule, is not a separate disease, but a consequence of various pathological processes. With virtually no effect on physical well-being, this disease significantly reduces the quality of life, complicates domestic, family, professional and social adaptation, inducing a number of psychological problems.

The main types of urinary incontinence in men are:

• Stressful. Urine excretion can provoke physical activity, coughing, laughter. The excreted amount of urine is usually insignificant;
• Urgent (imperative). The excretion of urine occurs due to an unbearable urge to urinate. As a rule, a large amount of urine is excreted.

Urinary incontinence in men: causes

The main causes of urinary incontinence in men are the result of:

• Age-related changes in the tissues of the prostate gland, pelvic muscles, organs of the genitourinary system;
• Cancer or adenoma (benign hyperplasia) of the prostate;
• Side effects of surgical treatment of the prostate gland;
• Damage to the brain or spinal cord, resulting in loss of bladder control;
• Infectious diseases in the lower urinary tract and bladder;
• Deposits of stones in the bladder, in the kidneys;
• Neurological diseases such as stroke, Parkinson's disease, multiple sclerosis;
• taking certain medications, such as antihistamines and decongestants;
• Stress, mental illness.

Urinary incontinence in men: treatment

Treatment of urinary incontinence in men is prescribed depending on the type of disease.

• Special exercises to strengthen the muscles of the small pelvis;
• Special exercises to strengthen the muscles of the perineum and sphincter apparatus - the Kegel complex;
• certain medications.

Treatment of urinary incontinence in men with an urgent type of disease is prescribed after determining the causes that cause it. Effective therapy of prostate adenoma or prostatitis, in case of their disease, can be a solution to the problem of urgent incontinence.

In diseases of the neurogenic or unknown nature of urinary incontinence in men, treatment is reduced to drug relaxation of the bladder muscle, removal of its involuntary contractions and an increase in the functional capacity of the bladder.

Male urinary incontinence should not be treated folk methods and means, since this can only aggravate the course of the disease.

To prevent incontinence, you should limit the use of alcohol, coffee, stop smoking and stop taking drugs that have diuretic properties. It is necessary to control your weight, since extra pounds can create an additional burden on the bladder and provoke urinary incontinence in men.

Bedwetting in men

Bedwetting in men is enuresis, a fairly common occurrence, especially in the age category over 45 years. More than half of all manifestations of enuresis in adult men are the result of untreated childhood diseases. In other cases, doctors ascertain acquired or so-called secondary nocturnal urinary incontinence in men.

Specialists qualify the following types of enuresis in men:

• Constant;
• recurrent;
• Acquired.

At the first manifestations of bedwetting, a man should immediately go to the doctor to get qualified medical care. Enuresis is not only a psychological problem, it can cause various diseases of the genitourinary system, such as inflammation of the bladder (cystitis).

Urinary incontinence in men: medications

When conservative therapy does not lead to a decrease in the frequency of urinary incontinence in men, drugs can only be prescribed by the attending physician.

In modern medicine, there are the following types of drugs for urinary incontinence in men:

• Alpha blockers (drugs based on terazosin, doxazosin, tamsulosin, alfuzosin). They stimulate relaxation of the smooth muscles of the bladder neck and prostate gland, normalize the outflow of urine and prevent disruption of bladder contractions leading to urgent incontinence. In general, alpha-blockers are used if urinary incontinence in men is a consequence of benign prostatic hyperplasia;
• 5-alpha reductase blockers (drugs based on finasteride, dutasteride). Drugs for inhibiting the production of dihydrotestosterone, which is the cause of benign prostatic hyperplasia. They are taken to reduce the frequency of urinary incontinence or retention in the bladder by reducing the size of the prostate gland;
• Tricyclic antidepressants (drugs based on imipramine). The drugs relax the muscles and block the nerve impulses that cause bladder spasms;
• Antispasmodics (drugs based on active ingredients: propanteline, tolterodine, oxybutynin, darifenacin, trospium chloride, solifenacin succinate). A class of drugs that relax muscles and reduce bladder spasms.

For simple urination disorders, the doctor may recommend treatment with homeopathic and phytotherapeutic preparations Urilan, Enuran, etc. For the treatment of age-related incontinence, homeopathic injections for men Super Optimal are practiced.

All drugs are prescribed by the attending physician after a comprehensive examination and the establishment of an accurate diagnosis.

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Deciphering the indicators of a general urine test

General urine analysis refers to mandatory diagnostic procedures that are assigned to all patients who apply to a healthcare institution.

Here we will tell you what indicators of urine are measured in a general urine test, and what diseases are indicated by certain deviations of these indicators from the norm. And also about how to properly collect urine for general analysis, analysis of daily urine and for analysis of urine according to Nechiporenko.

In the general analysis of urine, parameters such as specific gravity (relative density), color, transparency, odor, pH (acidity), protein content, glucose content, content of ketone bodies and bile pigments, and some other indicators are examined.

The results of the urine test are given to the patient in the form of a table with incomprehensible letters, which can only be read by a specialist. Below is a transcript of those same "incomprehensible letters", as well as the norms and possible deviations for individual indicators.

Deciphering the indicators of a general urine test

BLd - erythrocytes,
Bil- bilirubin,
Uro - urea,
KET ketones,
PRO protein,
NIT - nitrites (in the usual sense - bacteriuria),
GLU - glucose,
pH - acidity,
S.G - density,
LEU - leukocytes,
UBG - urobilinogen.

The table shows the main indicators of the general analysis of urine in the norm. Some of them will be discussed in more detail below:

The norm of a general urine test (table)

Interpretation of urinalysis indicators

The rate of urine analysis in adults and children (table)

Normal values ​​(in the field of view)

Acid-base reaction of urine is normal

Urine reaction (pH) of urine healthy person, located on a mixed diet, sour or slightly acidic.

Table: Urine acidity in children and adults is normal

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The specific gravity of urine (g / l) is normal

The specific gravity of the urine of a healthy person during the day can fluctuate in a fairly wide range, which is associated with periodic food intake and loss of fluid through sweat and exhaled air.

Table: The specific gravity of urine in adults and children is normal

The specific gravity of urine depends on the amount of substances dissolved in it: urea, uric acid, creatinine, salts.

• A decrease in the specific gravity of urine (hypostenuria) to 1005-1010 g / l indicates a decrease in the concentration ability of the kidneys, an increase in the amount of urine excreted, and drinking plenty of water.
• An increase in the specific gravity of urine (hyperstenuria) more than 1030 g / l is observed with a decrease in the amount of urine excreted, in patients with acute glomerulonephritis, systemic diseases, cardiovascular insufficiency, may be associated with the appearance or increase edema, large fluid loss (vomiting, diarrhea), toxicosis of pregnant women.

Protein in the urine, protein in the urine

Fine protein in urine missing. Appearance protein in urine is one of the most important symptoms of kidney and urinary tract disease. The appearance of protein in the urine is called proteinuria. Proteinuria is possible in healthy people after taking a large number food rich in proteins, after strong physical stress, emotional experiences.

Pathological proteinuria divided into renal (prerenal) and extrarenal (postrenal):

• Extrarenal proteinuriadue to the admixture of protein excreted by the urinary tract and genital organs; they are observed at cystitis, pyelitis, prostatitis, urethritis, vulvovaginitis. Such proteinuria rarely exceeds 1 g / l (except in cases of severe pyuria - the detection of a large number of leukocytes in the urine).
• Renal proteinuriamost often associated with acute and chronic glomerulonephritis and pyelonephritis, nephropathy in pregnancy, febrile conditions, severe chronic heart failure, kidney amyloidosis, lipoid nephrosis, kidney tuberculosis, hemorrhagic fevers, hemorrhagic vasculitis, hypertension.
  

Glucose (sugar) in urine (normal)

Carbohydrates (glucose) in urine a healthy person are contained in insignificant concentrations, their presence is almost always a sign diabetes. So, normally, urine contains glucose in the form of traces not exceeding 0.02%, which, like protein, is not detected by ordinary quality tests.

Urinalysis for red blood cells (normal)Source: http://med..php/%D0%B0%D0%BD%D0%B0%D0%BB%D0%B8%D0%B7%D1%8B/193-%D0%B0%D0%BD %D0%B0%D0%BB%D0%B8%D0%B7-%D0%BC%D0%BE%D1%87%D0%B8.html

Erythrocytes (red blood cells)normally, there are no urine sediments or single ones are found in the preparation. A general urine test in a healthy person should show no more than 2 erythrocytes in the microscope field of view, and no more than 3 leukocytes in men and 5 in women.

An increased number of red blood cells is characteristic of many diseases: pyelonephritis, urolithiasis, glomerulonephritis, urinary tract infections, systemic lupus erythematosus or poisoning(especially poisonous mushrooms, snake venom, benzene and aniline derivatives).

Urinalysis for leukocytes (normal)

Fine leukocytes in the urine are absent, or single ones are detected in the preparation and in the field of view. An increased content of leukocytes indicates possible pathologies of the kidneys or urinary tract: glomerulonephritis, pyelonephritis, urethritis, cystitis, prostatitis.

Leukocyturia (more than 5 leukocytes per field of view) can be infectious (bacterial inflammation of the urinary tract) and aseptic (with glomerulonephritis, amyloidosis, chronic renal transplant rejection, chronic interstitial nephritis). pyuria consider the detection in the sediment during microscopy of 10 or more leukocytes in the field of view.

Urinalysis for epithelium (normal)

squamous epithelium: in men, only single cells are normally detected, their number increases with urethritis and prostatitis. In the urine of women, squamous cells are present in greater numbers.

Transitional epithelial cells may be present in significant amounts acute inflammatory processes in the bladder and renal pelvis, intoxication, urolithiasis and neoplasms of the urinary tract.

Why does urine feel hot?

Both options indicate a possible infection, so it's important to seek medical attention, especially if there are other symptoms as well.

In this article, we look at what a normal temperature should be and what causes unusually hot or burning urination in men and women. We will also tell you when a person should visit a doctor and possible treatments.

What is the norm?

Urine usually has the same temperature as the body - 37°C on average. In 1992, they conducted a detailed study of the body temperatures of healthy men and women aged 18 to 40 years. Temperatures ranged from 35.6°C to 38.5°C, with an average of 36.8°C +/- 0.4°C. The lowest temperature was observed at 06:00, and the highest between 16:00 and 18:00.

When urine exits the urinary tract, called the urethra, it may feel warm on the skin it touches, such as the genitals, arms, or legs. At low ambient temperatures, a person can observe urine soaring.

If the urine feels warm or hot, this may be completely normal. Urine may feel especially warm if the person's body or hands are cold.

However, if a person notices that their urine seems warmer than normal or even hot as it exits the urethra, it could mean there is an infection or injury. A hot, burning, or painful sensation when urinating is called dysuria.

Symptoms

Feeling hot urine while urinating can be painful and may even cause a person to hold back urine. Parents of young children who do not want to urinate should consider the possibility of burning during urination. Most people who experience a hot sensation while urinating will notice other symptoms as well. It can be:
swelling in the genitals or urethra
discharge from the vagina or penis
fever
smelling urine
dark urine
cloudy urine
difficulty urinating
nausea and vomiting
back or stomach pain

Causes of hot urine

If a person's body temperature increases, for example if they have a fever caused by an infection, or if they have just been doing intense exercise, then their urine may also be warmer than normal.

The following is a list of causes that cause a feeling of hot urine or a burning sensation when urinating.

Urinary Tract Infection UTI (UTI)

Urinary tract infections are one of the most common reasons why urination becomes hot or burning. A UTI occurs when harmful bacteria, often E. coli, enter the urinary tract.

UTIs most commonly affect the bladder. People with a UTI may experience the following symptoms:
burning sensation when urinating
frequent need to urinate
intense urge to urinate even immediately after urinating
smelling urine
blood in urine

In most cases, antibiotic treatment will quickly cure a UTI. If left untreated, the infection can spread to the kidneys or other organs of the body. UTIs can occur in both sexes but are more common in women than men.

Other infection

One of the ways the body fights infection is through fever. This is why people often develop a fever when they are sick. When the urine is warmer than usual, it may mean that the person has a fever.

A fever can be caused by an infection anywhere in the body, so it's important to monitor symptoms and see a doctor if the condition doesn't improve.

When the urine physically feels warm and it burns when you urinate, it may mean you have a UTI or an infection in your kidneys.

Wounds in the urethra

Urine is acidic. This means that when it comes into contact with a wound, even a small one, the person may experience a burning sensation. A wound in or near the urethra can cause urine to leak out.

People who shave their genitals may have tiny cuts near the urethra. Friction injuries from intercourse, tiny pimples, cuts, and scrapes can create a feeling of hot urine.

Minor injuries usually go away on their own. If the urethra hurts, there is a fever, or there is a large wound, the person should visit a doctor.

Sexually Transmitted Infections (STIs)

Sexually transmitted infections can cause urinary tract problems. They can also damage the genitals or the area around the urethra, causing pain during urination.

Anyone who has had sex can contract an STI, even if there were no signs of illness at first. Some STIs do not give symptoms for a long time, so a long period without symptoms does not necessarily mean that there is no STI. Chlamydia is an STI that usually causes burning pain when urinating. It can also cause discharge from the vagina or penis, and in men it can cause swelling or damage to the testicles.

Interstitial cystitis

Interstitial cystitis is a poorly understood chronic disease that causes UTI symptoms even when there is no UTI.

This condition is more common in women than in men.

Researchers don't fully understand what causes it, but one possible cause is damage to the bladder tissue. People with interstitial cystitis may experience a burning sensation when urinating or other unusual sensations, such as feeling like the urine is too hot.

Causes in women

Reasons specific to women:

Wounds after childbirth

After childbirth, many women develop tears in the area between the vagina and anus, which are known as perineal lacerations. Tears can occur near the urethra or inside the vagina.

If urine comes into contact with these wounds, it can cause burning pain for several weeks after birth.

Irrigation of the perineum with warm water while urinating can relieve pain.

vaginal infection

A vaginal infection can irritate the tissue of the vagina and vulva. When irritated tissue comes into contact with urine, a burning sensation may be felt.

You can't diagnose a vaginal infection based solely on burning, so it's important to see a doctor when urination burns. This symptom can be caused by infections such as:
vaginal yeast infection
bacterial vaginosis
vaginitis
vulvodynia

Postmenopausal vaginal changes

After menopause, the body produces less estrogen. This can change the tissue of the vagina, causing it to shrink and loosen. The vagina may also feel dry, which can make the skin and other tissues sore.

When urine comes into contact with the vagina or urethra, it may feel hotter than before.

Causes in men

Causes specific to men:

Prostatitis

Prostatitis is swelling, pain, and inflammation in the prostate gland, often due to a bacterial infection. Men with prostatitis may experience pain or burning when urinating, as well as changes in the flow of urine.

There may also be nausea and vomiting, or pain during ejaculation. It is important to diagnose the cause of prostatitis, so people who suspect they have a prostate problem should see a doctor.

Epididymitis

Epididymitis is a tube that contains semen. An infection or inflammation in this tube can cause a painful burning sensation when urinating. Men with epididymitis may also experience swelling around the testicles, pain in the penis or testicles, and fever.

This painful condition is usually caused by a bacterial infection or after surgery and responds well to antibiotics and rest.

Treatment

Treatment depends on the cause. Because urine can feel hot for many reasons, and because many diagnoses have similar symptoms, it's important to see a doctor before attempting home treatment.

Many causes of painful or hot urination can be easily treated with antibiotics.

Drinking plenty of water can also help flush out bacteria from your urinary system and make your urine a little less acidic.

When to See a Doctor

When the only symptom is hot urination, it is not harmful, and it is often not dangerous to wait for the doctor to turn gray. You should immediately consult a doctor if:
very heat
back pain, as this may indicate a kidney infection
uncontrolled vomiting

See your doctor within a day or two for:
painful urination
smelling urine
frequent urination

Conclusion

Urine is hot in the body but cools quickly after it leaves the body. People who inadvertently put their hand into the urine stream may be surprised at how hot urine feels.

Most causes of hot urine are easily treated, and symptoms usually improve within a few days. Prostatitis, however, can be difficult to treat, and interstitial cystitis is a chronic pain syndrome. It is important to see a doctor who specializes in the treatment of urinary disorders in order to reduce the severity of the symptoms and decide on the appropriate treatment.

In most cases, nothing bad happens. When urine feels hot or painful, it's time to see a doctor. Most urinary problems are common and easy to treat, so there is no need to worry or be ashamed. In many cases, only a urinalysis and history is required for diagnosis.

Zawn Villains
"Medical News Today"

This is an uncontrolled leak of urine. Depending on the age in men and women, the causes of urinary incontinence differ. IN childhood girls develop control more quickly than boys bladder Therefore, bedwetting, or enuresis, is more common in boys. Adult women are much more likely than adult men to suffer from urinary incontinence. Urinary incontinence in women is associated with the anatomical features of the pelvis and the changes that occur during pregnancy and childbirth. However, urinary incontinence also occurs in adult men. Urinary incontinence in men is associated with age, but is not an inevitable companion of aging.

This is a treatable disease. Your doctor will help you determine the treatment for urinary incontinence.

There are three forms of urinary incontinence:

• stress urinary incontinence, manifested by leakage of urine during coughing, sneezing, lifting weights, that is, during activities during which intra-abdominal pressure rises.
• urge incontinence, manifested by leakage of urine after a strong urge to urinate, which cannot be stopped.
• overflow incontinence, which is manifested by the constant involuntary outflow of urine.

To hold urine and release it from the bladder into right time, the coordinated work of the muscles and nerves of the urinary system is necessary.

Nerves conduct signals from the brain to the bladder and sphincters. Any disease, condition, or injury that damages the nerves can lead to urinary problems.

Nerve damage

Nerve damage can occur at any age. In men with diabetes, damage to the nerve fibers can lead to impaired bladder control, i.e. urinary incontinence.

Stroke, Parkinson's disease and multiple sclerosis affect the brain and nervous system, thus, these diseases are the cause of problems with emptying the bladder.

overactive bladder is a condition that is characterized by frequent, urgent urge to urinate and urinary incontinence. The cause of an overactive bladder may be damage to the nerve pathways, but there may not be an exact cause for its development. Patients with an overactive bladder have two or three of the following symptoms:

• frequent urination - urinating more than 8 times during the day or two or more times at night
• urgency - a sudden, very strong, urgent urge to urinate
• Urinary incontinence is the leakage of urine that follows a sudden, strong urge to urinate.

spinal cord injury can lead to urinary incontinence, as the nerve pathways necessary to control the functioning of the bladder are damaged.

Prostate is a gland of the male reproductive system, which resembles a walnut in size and shape. The prostate gland surrounds the urethra below the bladder and secretes seminal fluid before ejaculation.

In older men, the prostate gland often enlarges. An enlarged prostate is called benign prostatic hyperplasia (BPH) or prostate adenoma. As the prostate gland grows in size, it compresses the urethra, disrupting the normal flow of urine. Lower urinary tract symptoms associated with the development of BPH are rare in men under 40 years of age, but occur in more than half of men over 60 years of age and more than 90% of men aged 70 to 80 years. The symptoms of BPH can vary, but the most common ones are associated with impaired urination: sluggish, intermittent urine stream, urgency, urinary incontinence or oozing, more frequent urination (especially at night) and urge incontinence. Urination disorders do not always indicate blockage of the outflow of urine caused by BPH.

Radical removal of the prostate

Complete surgical removal of the prostate gland (radical prostatectomy) is one of the treatments for prostate cancer. In some cases, after surgery, the development of erectile dysfunction and urinary incontinence in men is possible.

External beam radiation therapy

External beam radiation therapy is also a treatment for prostate cancer. Treatment results in temporary or permanent bladder dysfunction.

Prostatic Symptoms Scale

If the cause of urinary incontinence in a man is a disease associated with the prostate gland, the doctor will ask you a series of standard questions from the International Prostatic Symptoms Scale or the American Urological Association Prostatic Symptoms Scale. Here are some questions from the Prostatic Symptoms Scale:

• In the past month, how often have you urinated at intervals of less than 2 hours?
• During the last month, how many times did you get up to urinate during the night, from the moment you fell asleep until the morning?
• Over the past month, how often have you had the sensation of not emptying your bladder completely after you finished urinating?
• During the last month, how often have you had a weak urine stream?
• How often in the past month have you strained before urinating?

Your answers to these questions can help identify the problem and determine which diagnostic tests are needed. Your score on the Prostatic Symptom Scale is used as a baseline for determining the effectiveness of treatment and reducing symptoms.

Diagnosis of urinary incontinence in men

Disease history

The first step in treating urinary incontinence in men is to see a doctor. Your complete medical history, including any underlying illnesses or surgeries, details related to urinary incontinence, will help your doctor determine the cause of urinary incontinence in men. You should tell your doctor about the amount of liquid you drink during the day and whether you drink too much alcohol or coffee. You should tell your doctor about all medications you are taking, including over-the-counter medications (vitamins, herbs), as these can also lead to urinary incontinence.

Urination diary

You will be asked to keep a urination diary, which should record the amount of fluid you drink, as well as the number of times you urinate per day and the amount of urine you pass, including any episodes of urinary incontinence. Studying the urinary diary will help your doctor gain a better understanding of the problem of urinary incontinence and prescribe additional tests.

Urologist examination

On examination, the doctor will determine whether there is an increase in the size of the prostate gland or damage to the nerves. In a digital rectal examination, the doctor inserts a gloved finger of the right hand into the rectum and feels the prostate gland. A digital rectal examination helps your doctor get a general idea of ​​the size and condition of your prostate. In order to determine nerve damage, the doctor will conduct a neurological examination: check for sensory disturbances, changes in muscle tone and reflexes.

Electroencephalography (EEG) and electromyography (EMG)

Your doctor may order an electroencephalogram (EEG), a test that uses special electrodes attached to your head to record the electrical activity of your brain and look for abnormalities in your brain.

With electromyography (EMG), the wires are fixed in lower section abdomen to measure the activity of nerve endings in the muscles and muscle contractions, which can lead to the development of urinary incontinence.

Ultrasound examination (ultrasound)

At ultrasound examination The doctor uses a special transducer that sends ultrasonic waves into the body. Ultrasonic waves bounce off internal organs and return to the sensor. Special equipment creates an image of the internal organs on the monitor. To obtain images of the bladder and kidneys, the doctor performs an ultrasound scan, in which a transducer moves across the surface of the skin of the abdomen. In a transrectal ultrasound (TRUS) to obtain an image of the prostate, the doctor uses a special transducer that is inserted into the patient's rectum.

During urodynamic studies, the function of the bladder and urethral sphincter is determined. Urodynamic studies reveal violations of the contractile function of the bladder, the causes of urinary incontinence. Urodynamic studies involve measuring the pressure in the bladder after filling it with fluid using a special catheter. A urodynamic study helps to detect decreased bladder capacity, overactive or underactive bladder, weak urethral sphincter, or urinary tract obstruction. If a urodynamic study is performed simultaneously with electromyography (EMG), then abnormal nerve signals and uncontrolled bladder contractions can be detected.

The article is informational. For any health problems - do not self-diagnose and consult a doctor!

V.A. Shaderkina - urologist, oncologist, scientific editor