IRRITATIVE URINARY SYMPTOMS Irritative urinary symptoms include the following: *Frequency—urinating much more often than normal. *Nocturia—awakening from sleep to urinate. *Urgency—the sudden and strong desire to urinate. *Precipitancy—the need to get to the toilet in a hurry to prevent leakage. *Urgency Incontinence—the sudden and strong desire to urinate with an inability to get to the toilet in time to prevent an accident. Underlying causes of irritative voiding symptoms include: *Irritative focus within the bladder—bladder infection, bladder stone or foreign body, bladder tumor, stone in lower ureter. *Urinary tract obstruction—prostate enlargement, obstructive cystocele. *Sensory instability—a small capacity bladder that is excessively sensitive to filling. *Bladder instability—a bladder that contracts (squeezes) at inappropriate times and without its owner’s permission. *Bladder hyper-reflexia—a bladder that contracts at inappropriate times as a result of disease of the brain or spinal cord, including trauma, strokes, multiple sclerosis, etc. *Poor bladder compliance—a bladder with a rigid and poorly elastic wall that cannot stretch appropriately as the bladder fills. OBSTRUCTIVE URINARY SYMPTOMS Obstructive urinary symptoms include: *Hesitancy—a stream that is very slow to start. *Weak stream—a stream that lacks force or pressure. *Small caliber stream—a narrow and thinned stream. *Intermittency—a stream that tends to start and stop. *Straining—the need to use the abdominal muscles to generate a stream. *Prolonged emptying time *Incomplete emptying—the sensation of urine remaining in the bladder after completing urination. Underlying causes of obstructive voiding symptoms include: *Benign prostate gland enlargement *Prostate cancer *Excess muscle tone within the prostate and bladder neck *Urethral stricture—a scar within the channel that conducts urine from the bladder. *Poorly contractile bladder—a weak bladder muscle that cannot generate pressure to satisfactorily empty the bladder. *Urinary tract infection Source
