Urination problems can come in different forms. The exact problems must be differentiated according to Type, frequency, pain, timing and accompanying Symptoms.
In general, symptoms when urinating can include:
- A pain when urinating is called "Alguria“This is a common problem.
- The inability or. difficult urination is referred to as "Dysuria“.
- Opposed to this is the "Polyuria", I.e. the retired Urine volume is significantly higher and the urge to urinate more often. More about this at: Frequent urination
- If it is difficult to empty the bladder completely, you will have to for more often small amounts go to the toilet. One speaks of a "Pollakiuria“
- Increased Urination at night becomes "Nocturia" called
The causes of any urination problem are wide-ranging.
A Pain when urinating often occurs as a symptom of urinary tract infections. The urethra, the bladder, the ureter or the kidney itself can be affected by inflammation. Especially with Womenwho are significantly more prone to inflammation of the urinary tract, this is a typical clinical picture. The pathogens can bacterial and viral, but also Mushrooms be. Often it is intestinal bacteria. who find their way to the urinary tract through, for example, poor hygiene. But sexually transmitted diseases and fungal diseases can also cause inflammation and urination problems.
Especially at the beginning of urination there will be one brunning pain. Irritation of the urinary tract can also cause pain, for example in Urinary stones, smaller Injuries, after removal of a urinary catheter and in rarer cases Tumors.
At the man Urinary tract infection is also possible, but less common. A Inflammation of the prostate can be the cause of pain here. Older men in particular can benefit from it frequently Urge to urinate and urination problems. Almost 50% of male patients over the age of 50 develop one over time Enlargement of the prostateso that urination is affected. Over time, the bladder muscles also weaken, so that continence and bladder emptying are slightly restricted with age.
Very rarely are urination problems caused by Damage to a nerve arise, for example after a slipped disc.
Many patients regularly take medication, for example for high blood pressure, without knowing that an increased urge to urinate is typical side effect is. The increased urination at night, the nocturia, is also often caused by the interaction of (medicinal) increased urine production and incomplete urination Bladder weakness.
Differences between men and women
The main difference between male and female anatomy in this area is that different length of the urethra. At Men is this about 20 cm long, at Women just about 4 cm. That causes Women clear more vulnerable for germs ascending into the urinary bladder and thus for infections. It is important for women not to overcool the pelvis and lower back in winter. Additionally, it is a good one for women hygiene Essential when using the toilet and having sex to keep bacteria away from the urethra.
From halting or frequent urination women are generally less affected than men. The muscles of the urinary bladder can also weaken in them. However, prostate problems are not an option in women.
The main symptom “problems urinating” can be described and specified more precisely. Decisive for the diagnosis is whether it is a Burn acts or whether a disturbed or increased urination present. There are often other symptoms for any cause or underlying disease. Most painful urination is due to urinary tract or bladder infections. This infection can be accompanied by a fever, chills, body aches and headaches. These are typical signs of an infectious disease. Further therapy steps then result after a blood test and pathogen identification.
Also the kidney may be inflamed with painful urination. If it is inflamed, the patient feels very ill with typical infection symptoms. Additionally, strong ones occur Pain in the flanks which can be quickly identified by tapping on the middle lateral back.
Please also read our topic on this Kidney pain after a bladder infection
Will be one based on the age and gender of the patient Voiding disorder further investigations must be initiated. Typically one is palpable enlarged prostatethat restricts the outflow of urine.
Very rarely, nerve damage is responsible for urination problems. A pain in the back or an accident often preceded such damage.
Burning sensation when urinating
The typical burning sensation when urinating is in the vast majority of cases on one Infection of the lower urinary tract or bladder traced back. Young and sexually active women in particular are often affected. Also typical are patients who have had a urinary catheter placed during a long hospital stay. Every day you use the catheter, the risk of infection by a germ increases.
Mild urinary tract infections subside within a few days and are often only felt when urinating. With major bladder infections, there is also an increased feeling of illness.
Less common causes of burning sensation while urinating are Urinary stonesthat are excreted and irritate the mucous membrane from the inside, but also Inflammation of the renal pelvis. The latter is accompanied by a strong feeling of illness.
The detailed one is decisive for making a diagnosis anamnesetargeting accompanying symptoms, gender and age of the patient and an accurate description of the urination problem. It is just as important to distinguish whether pain occurs at the beginning or at the end of a urination as is the distinction between whether the patient is an elderly man or a young woman. Women suffer clearly more frequent infections of the lower Urinary tract and the bladder.
To secure a suspected diagnosis, a Urine sample or a smear of the lower urinary tract. This way, a pathogen can be identified and targeted therapy can begin.
Is there a suspicion that the prostate The cause of the urination problems are one Palpation examination through the rectum, a possible radiological image and a puncture of the prostate. In the case of problems with the urinary bladder, a simple ultrasound examination can provide information about the cause.
Which doctor should I see?
If you have initial symptoms and persistent urination problems, a visit to your doctor is recommended. If there is pain, he or she can arrange for urine tests and therapy.
If there is a problem with micturition over a longer period of time with the constant need to urinate, a urologist can be consulted. A urological cause is not uncommon, especially in men over 50 years of age.
If women experience recurring pain or after sexual contact, a visit to a gynecologist is recommended.
In any case, a doctor should be consulted after symptoms persist for several days. A general practitioner can often quickly isolate the causes and, if necessary, refer them to a urologist, gynecologist or another specialty.
Read more on this topic at: The urologist
Therapy and medication
Harmless urinary tract infections often heal on their own after a few days. A urinalysis is usually done for persistent, long-lasting symptoms. This can often be the trigger in the laboratory viral, bacterial pathogens, parasite or mushroom determine and a targeted, causal therapy can be carried out. This is usually medicinal and consists of Painkillersif there is more pain. In addition, a different agent must be applied depending on the pathogen. Be used in bacterial infections Antibiotics used. With stubborn fungal infections, so-called "Antifungal drugs" for use. In the case of bacterial infections, an “antibiogram” can be drawn up, which determines the ideal antibiotic for treating the respective pathogen.
Drink a lot helps a lot with urinary tract infections, as the flow through the kidneys and the bladder is increased and the pathogens can be flushed out faster. Additionally can warmthtaking the form of hot showers or a hot water bottle will help relieve symptoms. As a preventive measure, it is recommended that women urinate immediately after intercourse. In hospital operations, on the other hand, there is a maximum time for urinary catheters in place and precise hygiene regulations in order to keep the risk as low as possible.
If there are other urination problems, the cause must be determined so that treatment can be given. Is the cause with the prostate, can be diverse medicinal Therapy take place. Initially, an attempt is made to relax the muscles of the bladder neck with light means, initially with herbal remedies, later with so-called "alpha blockers". Even drugs that are in hormonal Processes intervene are used to shrink the prostate again. An operation can and must only be carried out if these therapies fail.
The prognosis in general is very good. Infectious diseases can be treated well. Depending on the pathogen, the disease subsides within several days to a few weeks. Fungal infections in particular can take a long time to complete. If the prostate is too big, this is not a dangerous condition, but rather an annoying condition. This can also be treated well.
If the prostate is enlarged, a malignant tumor must always be excluded. If this is the case, the therapy is completely different and the prognosis must be made dependent on other factors.
Problems urinating during pregnancy
Problems urinating in pregnancy are frequently. Especially in advanced pregnancy, the growing child in the uterus puts pressure on the bladder. The consequence of this is that it becomes too evident in advanced pregnancy frequent need to urinate With less discharge comes.
Many pregnant women also report having a strong urge to urinate but having difficulty emptying their bladder. This can be an indication that the baby is lying awkwardly. This is not a medical emergency, but it is still a good idea to consult a gynecologist.
Problems urinating in old age
The prostate grows with every man with advancing age. In men over 50, every second person has one zu large prostate. At around 75 years of age, almost every man has a postata that is too large, which can lead to problems with urination. That includes complicating and more frequent urination, as well as nocturnal urge to urinate, difficulties starting and dripping and sudden, uncontrolled urination. In old age, prostate enlargement becomes the main one medicinal treated with hormone preparations, more rarely with and Operations.
Problems urinating in children
Children are prone to urination problems in many ways. You are, whether boy or girl, more vulnerable for urinary tract infections as adults. That is due to the shorter length of ureters and the lower hygiene awareness of children. In small children in particular, it is important to prevent the inflammation from rising to the kidneys.
A typical complication in young boys is the so-called Phimosis. This is a constriction of the foreskin on the penis, which in boys can make urination much more difficult and leads to urinary congestion.
Problems urinating after surgery
Discomfort when urinating after surgery can have several causes. In the course of some operations, especially larger ones, the patient has to be intermittent Urinary catheter be placed. After pulling the catheter, some people find it difficult to urinate normally again. The urinary tract can also pass through the catheter irritated and make urination difficult. Sometimes it expresses itself painful.
A typical illness in inpatients are Urinary tract infections. These can occur at any time for no apparent cause. But also through urinary catheters are Infections favoring the urinary tract and bladder. The pathogens can ascend into the bladder along the catheter. For this reason there are urinary catheters for such strict hygiene rules in hospitals.
Problems urinating in public
A typical problem with urination is that inability, urinating in public. Men who use public toilets are particularly affected. The problem is called "Paruresis" and is mentally conditionally. Fearing other people's thoughts in the public toilet, the bladder neck muscles tense up and make it impossible to urinate.
The problem increases on its own if those affected are under pressure when the problem occurs and the fear make it worse. Once the spell is broken, urination works, even if people are still entering the toilet.