What is the reason for urine retention

Urinary incontinence is a common urinary system disease. The occurrence of urinary incontinence is related to various situations and is a urination dysfunction. The so-called urine fasting refers to the automatic and inadvertent leakage of urine by a person. For example, some people will urinate involuntarily when they talk loudly, cough, or even stand normally. This is a very embarrassing thing and has a great impact on people. So why does urinary incontinence occur?

There are many causes of urinary incontinence, mainly due to problems with the nerves and tissues that control the urge to urinate: atrophy and relaxation of the pelvic floor muscles at the bladder neck, and dysfunction of the urethral sphincter. Normally, the urethra can resist any increase in abdominal pressure without causing urinary incontinence. When the pelvic floor muscles relax and the bladder bottom and proximal urethra shift downward, the increased abdominal pressure can cause a corresponding increase in the intra-bladder pressure. However, the urethral sphincter relaxes and the urethral resistance decreases, which can cause urinary incontinence. The clinical manifestations are: urine leakage when laughing, coughing, sneezing, running, jumping, exerting sudden force, and having sexual intercourse.

The clinical manifestations of urinary incontinence can be divided into five categories: overflow incontinence, non-resistance incontinence, reflex incontinence, urge incontinence and stress incontinence.

1. Overflow incontinence is caused by severe mechanical (such as prostatic hyperplasia) or functional obstruction of the lower urinary tract, which leads to urinary retention. When the intra-bladder pressure rises to a certain level and exceeds the urethral resistance, urine drips continuously from the urethra. In these patients, the bladder is distended.

2. Non-resistance urinary incontinence is caused by the complete loss of urethral resistance. The bladder cannot store urine, and all the urine flows out of the urethra when the patient stands.

3. Reflex urinary incontinence is caused by complete upper motor neuron lesions. Urination relies on spinal cord reflexes. Patients urinate intermittently (intermittent urinary incontinence) involuntarily and have no feeling of urination.

4. Urge urinary incontinence can be caused by strong local stimulation such as partial upper motor neuron disease or acute cystitis. Patients have very serious symptoms of frequent urination and urgency. Urinary incontinence occurs due to strong, uninhibited contractions of the detrusor muscle.

5. Stress urinary incontinence occurs when urine flows out of the urethra when abdominal pressure increases (such as when coughing, sneezing, going down stairs or running). Stress urinary incontinence is mainly related to relaxation and incomplete closure of the bladder and urethral sphincter, and the main cause is kidney qi deficiency and weak bladder.

The typical symptom is that when the patient is standing, the abdominal pressure suddenly increases due to coughing, laughing, sneezing, lifting weights, running, jumping, going down stairs and strenuous activities, and urine flows out of the urethra involuntarily. In mild cases, only a few drops will flow out occasionally, while in severe cases, it will drip continuously.

Stress urinary incontinence can be divided into three degrees according to clinical manifestations: Grade I: Urinary incontinence occurs when coughing, laughing, sneezing, exerting force, or engaging in strenuous activities. Grade II: Urinary incontinence may occur with slight exertion such as standing, walking, holding breath, or when standing up from a sitting position. Grade III: Urinary incontinence is not related to activity, the patient cannot feel the dripping, and the pants are often wet. Urinary incontinence can occur when lying down, that is, urinary incontinence can occur anytime and anywhere.