More Urology Answers
Question Library
Ask a question about Urology
Volunteer
Experts of the Month
Expert Login
Awards
About Us
Tell friends
Link to Us
Disclaimer
|
| |
|
|
| |
| | | |
About Arthur Goldstein, M.D.
Expertise
Any problems or questions related to the field of urology; ie urinary stone disease, urinary cancers (kidney, bladder, prostate, testis, etc.), urinary infections, impotency, etc.
Experience
I am retired from the active practice of urology. My 34 years was totally in the clinical field and involved the entire gamut of genitourinary problems, with special interest in male impotence and endourology.
Organizations
American Medical Association, American Urological Association, American College of Surgeons
| | |
| |
You are here: Experts > Health/Fitness > Urology > Urology > incomplete urination
Expert: Arthur Goldstein, M.D.
Date: 10/6/2008
Subject: incomplete urination
Question
Hello, I am a 62 yr. old woman. My issue is that even though my bladder feels painfully full when I awake I hardly manage to dribble anything out and can't even forcefully push out any more but if I sit there for a few moments I eventually urinate only a little more. I've never had a huge stream of urine...it almost sounds funny, but if I'm in a public bathroom and hear someone in the next stall it seems to sound so much different than my stream...theirs has quantity and force. Any ideas?
thanks,
Vicki
Answer
Vicki, you need to make an appointment with a urologist for a full evaluation. There are many conditions that may cause this. Ones ability to urinate depends on 2 opposing factors: the force with which the bladder muscle contracts which has to work against the resistance in the urinary canal (urethra). Anything which decreases the former or increases the latter make it more difficult to urinate and empty the bladder efficiently. Normally, after urination the bladder should retain less than 30 cc (one ounce) of urine. This is called the "residual urine". Excessive “residual urine” can predispose to urinary infections and kidney damage from back pressure. In addition, chronic distention of the bladder muscle prevents it from contracting with maximum force which exacerbates the residual urine accumulation. In women, poor vaginal support of the bladder &/or uterus can cause a cystocele (sagging bladder) or uterine prolapse (procidentia) which can both interfere with normal bladder evacuation. Bladder contractile force can also be adversely affected by a number of medications including those used for anxiety, depression, pain (especially narcotics), GI disorders, & many other conditions. Furthermore, putting off the desire to void by holding your urine too long over-stretches the bladder muscle which then may not be able to
contract forcefully enough to empty. Urinary retention can also be precipitated by excessive alcohol as this is a central nervous system
depressant. Alcohol may also prevent you from being aware that your bladder is
full before it is too late. Certain neurologic diseases, such as herniated discs, MS, parkinsonism, etc. often adversely affect bladder emptying.
Disorders that may increase the resistance in the urethra include urethral stricture (narrowing), cystoscele, uterine prolapse, urethral stenosis, etc. Estrogen deficiency may be a factor in some cases. As there are so many disorders that can cause you voiding difficulty, you need to see a urologist in consultation . A complete history, physical examination and some laboratory tests need to be done. At the very least, measurement of your residual urine will be done. Depending on the above, further testing such as a cystoscopy. urodynamic studies, and imaging of the upper urinary tract may be indicated. Do not wait any longer to get checked out! Although this might sound complicated, usually the problem can be managed quite successfully by relatively simple means. The key to treatment, however, is find the cause for your symptoms. Good luck.
Add to this Answer
Ask a Question
|
|
