Frequent urination (pollakiuria) is observed with cystitis, a decrease in the volume of the detrusor, urethritis, STIs, kidney diseases, and some andrological, gynecological and endocrine pathologies. Sometimes it has a psychogenic nature. The cause of the symptom is established based on the data of the survey, physical examination, the results of laboratory and hardware techniques. Treatment includes the appointment of antibiotics, NSAIDs, hormones and other drugs, non-drug methods, and surgical interventions.
Normally, an adult produces 1.5-2 liters of urine per day. The frequency of mictions in most cases ranges from 3 to 7 times, during one urination, 200-30 ml of urine leaves. They say about pollakiuria, if the patient visits the toilet more than 1 time, while the portions of urine, as a rule, decrease. In children, urination is more frequent: in newborns from 12 to 16 times, up to 3 years - about 1 time, from 3 to 9 years - 6-8 times.
In the absence of provoking diseases, the cause of short-term pollakiuria is:
The most common cause of pollakiuria is nonspecific infectious acute cystitis and chronic inflammation of the bladder during periods of exacerbations. Mictions are painful, with burning and cutting at the final stage. Pain over the womb is determined, sometimes cloudy urine, a slight increase in body temperature. Taking into account the gender and characteristics of the hormonal status, the following variants of the disease are distinguished:
Specific tuberculous cystitis occurs when the pathogen spreads with urine in patients with kidney tuberculosis. Characterized by weakness, weight loss, stranguria, urgent urges, pain above the pubis.
Interstitial cystitis is typically chronic. Initially, the symptoms are mild. As the morphological changes in the organ worsen, dysuric disorders increase: pollakiuria, nocturia, incontinence occurs. Radiation cystitis develops during or after the end of radiation therapy. In acute inflammation, the symptoms resemble ordinary cystitis. In the chronic form, there is a persistent increase in urination, incontinence, imperative urges.
A wrinkled bladder (SMP) develops as a result of tuberculosis, interstitial and chronic radiation cystitis, and some other pathologies. The number of urination is up to 2 or more times a day. Pollakiuria is complemented by nocturia, urgency incontinence. One of the causes of SMP is long-term current paracystitis.
Frequent urination with paracystitis occurs at the initial stage, during the formation of an abscess, is complemented by intense pain, intoxication syndrome. Then the abscess breaks, a large amount of pus is released from the urethra, the condition returns to normal. In chronic course, there is a replacement of perivesical tissue with fibrous tissue with the formation of SMP and the re-development of pollakiuria.
In a ureterocele, the lower portion of the ureter expands and bulges into the bladder cavity. With large hernias, the volume of the detrusor decreases, which causes a rapid accumulation of urine in the remaining space. Urine is excreted frequently, in small portions. With the blockade of the second ureter, the formation of acute hydronephrosis is possible, with the descent of a hernia into the urethra in women, the occurrence of complete urinary retention.
Acute nonspecific bacterial urethritis is manifested by burning, itching, pain during micturition, the appearance of mucopurulent or purulent discharge from the urethra. The general condition is not broken. Pollakiuria, as a rule, is insignificant, due to unpleasant sensations in the urethra. Urethral diverticula are often asymptomatic for a long time. With the development of complications, there are difficulties, frequent urination, dysuria, incontinence, pain in the groin.
The appearance of a symptom in sexually transmitted infections is associated with the development of specific urethritis. Pollakiuria is observed in mycoplasmosis in men. Decreased libido and erectile dysfunction are combined with pollakiuria, nocturia, cramps, pain, swelling, hyperemia. Gonorrhea manifests suddenly, is manifested by pain, burning, creamy purulent discharge. With the defeat of the back of the urethra in men, significant hyperthermia is determined. Frequent urination is sometimes detected with trichomoniasis, chlamydia, candidiasis in men. It is expressed indistinctly.
Pollakiuria accompanies the following renal pathologies:
The development of pollakiuria is typical of an overactive bladder. Pathology accompanies multiple sclerosis, some types of polyneuropathy. There is nocturia with or without urgency and urge incontinence. In patients with overactive neurogenic bladder, frequent urination is accompanied by incontinence and autonomic disorders. Etiofactors are spinal cord injuries, circulatory disorders, encephalitis, strokes, malformations of the brain and spinal cord.
Most often, the symptom is found in diseases of the prostate gland. The reason is a decrease in capacity and secondary changes in the bladder. The prostate compresses the urethra, therefore, pathologies of this group are characterized by difficulties at the beginning of micturition, a weak stream. Frequent urination is observed with prostatitis, prostate adenoma, prostate cancer.
In patients operated on for adenoma or cancer, sclerosis of the bladder neck can act as an etiological factor in pollakiuria. The lethargy of the jet is complemented by a feeling of incomplete emptying, the symptom joins with the development of secondary inflammation. With hypertrophy of the seed tubercle, the jet is weak, intermittent. Requires straining. Premature ejaculation, pain during erection are possible.
Increased urination is found in the following diseases of the female genital organs:
The symptom often accompanies endometriosis, especially in the presence of pathological foci in the bladder zone and adjacent areas. Pollakiuria is a common problem in women suffering from weakness of the pelvic floor muscles. May be accompanied by stress or urgency incontinence.
The most obvious sign of diabetes is constant thirst. A large amount of fluid you drink causes polyuria and, as a result, frequent urination. The symptom is more pronounced in type 1 diabetes. In patients with type 2 diabetes, drowsiness, itching, blurred vision, and skin infections come to the fore. Pollakiuria is also observed in Wolfram's syndrome, a hereditary pathology, one of the manifestations of which is diabetes mellitus.
In addition, the violation is detected in steroid diabetes mellitus. In people with diabetes insipidus, the amount of daily urine reaches 1 or more liters. Mictions are frequent, in large portions. Urine is colorless, "diluted". Antidiuretic hormone deficiency is also seen in hypopituitarism, the clinical presentation of which includes diabetes insipidus, hypogonadism, hypothyroidism, and hypocorticism.
Polyuria and pollakiuria develop against the background of alimentary dystrophy caused by voluntary or forced starvation. The symptom is found in vegetative and mental disorders, including:
Tests for pollakiuria
Diagnostic measures are carried out by a urologist. According to indications, an andrologist, gynecologist, endocrinologist and other specialists are involved in the examination. If a mental disorder is suspected, patients are referred for a consultation with a psychotherapist or psychiatrist. As part of the conversation, the specialist determines the time of occurrence and the severity of frequent urination, the presence of other manifestations that indicate the nature of the disease. Patients are asked to complete a special diary.
During a general examination, the doctor identifies areas of pain, conducts special tests (for example, checks Pasternatsky's symptom), assesses the general condition of the body, nutritional level, etc. Women are shown an examination on a chair, men with suspected andrological pathology - a digital examination of the prostate. With neurogenic disorders, a neurological examination is performed. The plan of additional examinations includes such procedures as:
Therapeutic tactics is determined by the cause of the development of pollakiuria:
Taking into account the etiology of frequent urination, such surgical interventions are performed as: