FREQUENT MICTURITION,
URGENT MICTURITION
AND DYSURIA
Xiaoqi Xu
Renji Hospital
Shanghai Second Medical University
CONTENT
? Definition
? Etiology and clinical appearance
? Accompanied symptoms
? Approach to the patient
Definition
? Frequent micturition,
voiding at a frequent intervals,due to a
sense of bladder fullness
Normal,3-5 times in the day time
0-1 time in the night
200-400ml each time
Definition
? Urgent micturition,
an exaggerated sense of needing to
urinate due to an irritable or inflamed
bladder
? Dysuria,
pain or a burring sensation during
micturition
irritation sign of bladder
ETIOLOGY AND CLINICAL
APPEARANCE
Frequent micturition
A.micturition increased but the volume
each time is normal
? diabetes mellitus,
? polyuria period of acute renal failure
? diabetes insipidus
Frequent micturition
B.micturition increased and the volume each
time is decreased,
? bladder or urethra irritation,
bladder,post urethral inflammation
bladder tuberculosis or stone.(esp TB,
frequent micturition can last for long time)
Frequent micturition
? diminished capacity of bladder,
neoplasm
contracture of the bladder(TB)
pregnant uterus
hysteromyoma press on the bladder
hysteroptosis
Frequent micturition
? obstruction of the lower urinary tract,
prostatic hyperplasia
often seen in man after age 40
accompanied by force of the urinary
system,hesitancy in initiating voiding,
postvoiding dribbling and the sensation
of incomplete emptying
Frequent micturition
? neurogenic bladder,
history of neurologic disease
? psychogenic cause,
nervous,worry,dread,
Urgent micturition
? acute cystitis,urethritis,prostatitis,
ureter stone,bladder cancer,neurogenic
bladder etc,
? urgency is commonly associated with
frequency and dysuria,
Dysuria
? urethritis,cystitis,prostatitis,bladder
tuberculosis,stone,foreign body,end-stage
bladder cancer
urethritis--
dysuria occurs at the beginning of micturition,
cystitis--
can be aggravated the pain at the end of
micturition,
Dysuria
prostatitis--
can also cause discomfort in the lower
abdomen,groin,perineum,rectum,testes or
penis,
bladder calculi or foreign body--
voiding pause during micturition,
bladder tuberculosis--
concomitant with evidence of TB and
hematuria
ACCOMPANIED
SYMPTOMS
frequency,urgency and dysuria
? with fever and pyuria,acute cystitis
? discomfort in the lower abdomen,groin,
testes,acute prostatitis
? with hematuria and evidence of
systemic TB,bladder TB
? frequency,urgency and aggravated pain at the
end of micturition,
stone in the lower part of ureter
? male with age over 50,frequency and
progressive straining to void,
prostatic hyperplasia
? patients over 40 years old hematuria without
pain or hematuria appearing after the
fuequency,urgency,dysuria,
bladder cancer
? with the history of neurologic diseases
and signs,
neurogenic bladder
disorder of feeling and motion in inferior
extremity
sphincter ductus choledochi (肛管括约肌 ) is
flabby or the reflex disappears
Approach to the patient
history-past and
present urinary
problems
PE- incl.pelvic ♀
prostatic♂
urinary analysis,leukorrhea ♀
prostatic fluid ♂,culture,
ultrasound,excretory
urography,voiding
cystourethrography
urologic evaluation-
cystoscopy,urethroscopy,
endoscopic biopsy,dynamic
urinary tract studies
DIAG
NOSIS