The act of urination. The study of the act of urination. Bladder emptying phase
Urine, constantly produced by the kidneys, passes through the ureters to the bladder, a hollow muscle-walled organ in which it accumulates before being excreted through the urethra during urination.
- a series of interconnected hollow structures that remove urine from the body several times a day in the process of urination. The urinary tract, starting in the kidneys, exits into the renal pelvis, a funnel-shaped formation that passes into the ureters, two long tube-like canals that run through abdominal cavity to the pelvis and flowing into the bladder. This hollow organ with strong muscular walls contains urine, gradually filling up, and then withdrawing through the last section of the urinary system, the urethra, to the outside.
Ureter- a tube through which urine flows from the renal pelvis to the bladder (MP). In the figure, the ureter is shown enlarged and with a cut wall. A segment of the filled ureter is opened and drawn around the empty ureter. The following shells characterize:
- mucous membrane(SO) consists of transitional epithelium (E) and lamina propria (LP) of the mucosa, formed by a relatively thick layer of well-perfused and innervated loose connective tissue. The mucous membrane of the empty ureter forms several longitudinal folds. As the ureter expands, as shown by the arrows, the folds flatten.
- Muscular membrane(MO) consists of bundles of smooth muscle cells, between which are layers of loose connective tissue. They are not always well separated from each other, but it is possible to distinguish between the inner longitudinal (IL) and the middle circular (MC) layers; in the lower part of the ureter, located in the pelvic area, an outer longitudinal (OL) layer appears (not shown in the figure). Regular downward peristaltic contractions, starting in the small cups, are transmitted to the muscular layer of the ureter. During these contractions, which move urine toward the bladder, the ureter expands and contracts as shown by the arrows.
- adventitial sheath(AO) - a layer of loose connective tissue rich in fat cells, blood and lymphatic vessels, and nerve fibers.
This is a hollow extensible organ: when it is empty, it has a more or less triangular shape, but as it fills up, it takes on an oval or spherical shape; usually in an adult it can hold up to 350 ml of urine. The bladder is made up of three different parts: tops- the upper part, which is lined with peritoneum from the outside; body, which makes up most of the organ, containing two openings at the back, through which urine flows from the kidneys through the ureters into the bladder, and basics, resting on the bottom of the pelvis and forming the neck of the bladder, which passes into the opening of the urethra.
The urethra is a channel - the last section of the urinary system, through which urine from the bladder is excreted. In women, the urethra performs only this function, while in men it also removes sperm from the internal genital organs at the time of ejaculation. The urethra starts at the urethra and ends at the external opening. urethra, or urinary canal, on the surface of the body.
The female urethra is 4-5 cm long; it follows a straight downward path, ending with the urinary canal at the vulva. The male urethra reaches a length of 15-20 cm. There are three segments of the male urethra: the first, prostate urethra, crosses the prostate; second, membranous urethra, runs from prostate to the root of the penis; and third, spongy area urethra, runs along the inside of the penis inside the spongy body, ending with the urinary canal on the glans penis (More details in the article "Urethra").
Urine is in the bladder temporarily because, despite the fact that the muscles of the walls of the bladder are elastic, its ability to accumulate urine is limited: accumulated beyond measure, urine is thrown out through the urethra due to the mechanism of urination. This mechanism relies on a muscular valve located at the outlet of the bladder that allows the urethra to close and open to release urine from the body.
This muscular valve is known as the urinary sphincter; it consists of two structures that create an obstacle to the passage of urine: the internal urethral sphincter, located at the point of transition of the bladder into the urethra, and the external urethral sphincter, located in its middle section. The first works automatically, and the function of the second can be controlled up to a certain point, so a person is able to delay urination.
The ability to control the activity of the external urethral sphincter comes in the first years of a child's life, children learn to distinguish signals indicating the filling of the bladder, and to restrain automatic urination reflexes by the age of two. The emptying of the bladder occurs due to automatic urinary reflex, which acts when the walls of the bladder expand beyond a certain limit. When this happens, nerve receptors in the walls of the bladder send a signal that reaches the micturition center in the spinal cord, upon receiving which the nerve center sends motor impulses to the muscles of the bladder walls. Then the detrusor muscle, which is part of the bladder, contracts and opens the internal urethral sphincter, allowing urine to pass into the urethra. However, for urine to come out, the external urethral sphincter, which is under mind control, must also relax. 
The act of urination includes two phases - filling the bladder (reservoir function) and excretion of urine (evacuation function). Both phases are inextricably linked with each other.
Normally, the first phase is characterized by contraction of the sphincter and the creation of high pressure in the urethra, which prevents the flow of urine. The reservoir function is characterized by the fact that the intravesical pressure is low (10-15 cm of water column), and the intraurethral pressure is 70-80 mm of water. Art.
In the second phase, the detrusor contraction and simultaneous relaxation of the sphincter occur. As a result, urethral pressure decreases, resistance to urine flow in the urethra disappears, and voluntary urination occurs. This whole process is regulated by the brain and spinal cord.
A large role in the synergistic interaction of the sphincter and detrusor belongs to a-adrenergic receptors.
Usually the urge to urinate occurs when the bladder is filled with 250 ml of urine. Thus, a healthy person urinates 5-6 times a day, and during the daytime. At night, due to physiological processes (reduction in the formation of urine excretion by the kidneys under the influence of hormones), healthy person there should be no urge to urinate.
In children under 2-3 years of age, physiological detrusor hyperactivity is noted, which is usually accompanied by the appearance of involuntary urination.
o Difficulty urinating
o strangury
o Urinary incontinence
o Painful urination
o Pollakiuria
o Urinary retention
o Acute urinary retention, causes of urinary retention.
Difficulty urinating- may be due to both mechanical factors and violations of the innervation of the bladder.
Urethral strictures are manifested by a thin stream of urine. Ultimately, complete retention of urine may occur with or with the release of it only drop by drop.
With prostate adenoma, difficulty urinating is usually accompanied by a weak jet pressure with the disappearance of the usual arcuateness, but its width in such patients decreases, as a rule, slightly.
stranguria- a combination of difficulty urinating with increased urge and soreness. Usually there is a painful urge to urinate, but little urine is released, there is always a feeling of insufficient emptying of the bladder. It is observed with cystitis, prostatitis, vesiculitis, stones, tuberculosis, tumors, especially when the process is localized in the bladder neck.
Urinary incontinence- involuntary release of it without urge to urinate due to relative or absolute insufficiency of the sphincter of the bladder of organic or functional origin.
In addition, there are stress, urge incontinence, overflow incontinence, temporary (transient) incontinence.
Distinguish between true and false urinary incontinence.
true urinary incontinence manifested by arbitrary, without the urge to urinate, the release of urine drop by drop to the outside. The bladder remains empty (unlike paradoxical ischuria). This form of urinary incontinence occurs with vesico-vaginal fistulas, exstrophy of the bladder, total hypo- and epispadias, impaired innervation of the sphincter of the bladder, and diseases of the brain and spinal cord.
False urinary incontinence characterized by persistent urinary incontinence along with normal urination. It is observed with ureterovaginal fistula, ectopia of the mouth of the ureter in the vagina, on the eve of the vagina.
Painful urination appears in various acute or chronic diseases of the bladder, prostate, posterior urethra. According to the time of occurrence, pain can occur with the urge to urinate, during the act of urination, immediately after it. Pain in the bladder can also appear out of connection with urination. Painful urination often accompanies pollakiuria.
Urinary retention. This symptom refers to the inability to voluntarily expel some or all of the urine contained in the bladder through the urethra.
Distinguish between partial and complete urinary retention. With partial retention of urine, the patient urinates on his own, but complete emptying of the bladder does not occur, and after each urination, a certain amount of urine remains in the bladder, which is called "residual". The amount of residual urine can be determined using ultrasound, radioisotope, x-ray and other research methods. This condition has another name - chronic incomplete urinary retention. The mechanism of this symptom is associated with a gradual decrease in the tone of the bladder detrusor. The progression of this process, together with the associated decrease in the tone of the sphincter and the loss of its ability to retain urine, lead to the onset of a paradoxical situation: against the background of the absence of independent urination, urine is excreted from the overflowing bladder drop by drop. This form of urinary retention is called paradoxical ischuria.
Unlike the previous form, when independent urination persists, paradoxical ischuria, apparently, with a certain convention can be called chronic complete urinary retention.
Acute urinary retention. From the very name of this form of urinary retention, it follows that it occurs suddenly. Unlike anuria, in acute urinary retention, the bladder is full, the patient is disturbed by imperative, but unsuccessful urge to urinate.
At the heart of acute urinary retention are mechanisms associated with obstruction (squeezing and deformation of the urethra) and disorders of the nervous regulation of the muscles of the bladder.
Causes of urinary retention
A. Neurogenic diseases:
Organic diseases of the brain (hemorrhage, thrombosis, etc.);
spinal cord injury;
Compression of the spinal cord in tuberculous spondylitis;
myelitis;
Dorsal tabes;
Metastases in the spine;
Hysteria;
Primary atony of the bladder;
Reflex urinary retention. With all types of neurogenic urinary retention, there is no mechanical obstruction along the urethra.
B. Mechanical obstruction to the outflow of urine (infravesical obstruction):
Urethral stricture, bladder neck sclerosis;
Urethral stone;
Rupture of the urethra;
tumor of the urethra;
prostate abscess;
Adenoma (benign hyperplasia) of the prostate;
prostate cancer;
Contracture of the neck of the bladder;
Compression of the urethra by tumors, inflammatory infiltrates;
Foreign bodies of the urethra.
In addition to urinary retention, in the clinical picture in such patients, it is important to take into account the symptoms of the disease that caused the delay.
So, with chronically flowing primary atony of the bladder, patients complain of a feeling of heaviness in the lower abdomen and a fetid smell of urine. They urinate on their own, but sometimes there is paradoxical ischuria. Palpation reveals an overflowing bladder. With the help of a catheter, up to 1 liter of urine or more can be removed.
Reflex postoperative urinary retention occurs more often after surgery on the perineum, on the rectum, on the organs of the female reproductive apparatus, less often after surgery on the abdominal organs. It can also occur with other (non-surgical) injuries of the perineum, pelvis, and lower extremities.
In pelvic injuries without damage to the urinary tract, reflex urinary retention can be the cause of an erroneous diagnosis - rupture of the urethra.
The clinical picture of urinary retention in adenoma, prostate abscess and other diseases will be described in the relevant sections.
Actions of the doctor in case of acute urinary retention:
Bladder catheterization with an elastic or metal catheter; it is a medical manipulation, especially in men;
Capillary puncture of the bladder; performed when catheterization is not possible or in case of trauma to the urethra (followed by urgent surgery - primary urethral suture);
Suprapubic epicystostomy;
Trocar cystostomy.
Pollakiuria- increased urination. It is more common in diseases of the lower urinary tract. Reflex pollakiuria occurs due to diseases of the kidneys or ureters (for example, with stones in the intramural ureter). Pollakiuria is often accompanied by an imperative (imperative) urge to urinate, leading to the inability to hold urine. Daytime pollakiuria is usually observed with bladder stones, nighttime is characteristic of benign prostatic hyperplasia. With tuberculosis, tumors, inflammatory diseases of the bladder, increased urination! may be day or night. Reception of some medicines may also cause pollakiuria.
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The bladder is an unpaired organ that serves to accumulate urine continuously coming from the ureters and performs an evacuation function - urination. It has an inconsistent shape and size, depending on the degree of filling with urine. Its capacity is individual and ranges from 250 to 700 ml.
The bladder is located in the pelvic area behind the pubic symphysis. The relationship of the bladder with other organs in men and women is different. In men, the rectum, seminal vesicles and ampullae of the vas deferens are adjacent to it, and in women the cervix and vagina.
The bladder is divided into apex, fundus, and body. The place of its transition to the urethra is the neck. The wall of the bladder consists of three membranes: mucous, muscular and external (serous). The mucosa is mobile and forms numerous folds, which are smoothed out when the bladder is stretched. In the bottom area, the location is a plot in the form of a triangle, devoid of folds. Its name is Lieto triangle. Here the mucosa tightly fuses with the muscular membrane. The vertices of the triangle are the openings of the ureters and the mouth of the urethra.
The muscular layer has 3 layers: outer and inner - longitudinal and middle - circular. This sheath is often referred to as the urine expelling muscle. In the region of the mouth of the urethra, the circular layer forms the sphincter of the bladder, which plays an important role in the retention of urine.
mechanism of urination. The bladder is filled with urine up to certain limits without changing the intravesical pressure. With further accumulation of urine, the pressure begins to grow and at a certain moment irritation of the receptors of its mucous and muscular membranes occurs. Further, the inclusion of one or another mechanism of urination depends on the age of the person and his individual characteristics. In infants, this process is controlled only by the spinal cord. It gives a signal and the bladder is automatically emptied, the internal sphincter contracts and relaxes.
From about the age of two, a center of urination is formed in the cortex of the frontal lobes, which allows you to delay urination for a while, or vice versa, to carry it out, even when the bladder is not full. The contraction of the external sphincter can delay urination or interrupt the flow that has already begun.
It is impossible to delay urination for a very long time. With critical filling of the bladder, all sphincters relax and emptying follows.
Involuntary urination in older children and adults, as well as bedwetting (enuresis), are indicative of damage. nervous system and require special examination and treatment.
The average daily amount of urine in a healthy person is 1500 ml. This volume is approximately 75% of the liquid taken per day, the remaining 25% are excreted from the body by the lungs, skin, and intestines. The frequency of urination per day ranges from 4 to 6 times. The bladder empties completely during urination. Urination itself lasts no more than 20 seconds at a urine flow rate of 20-25 ml/sec in women and 15-20 ml/sec in men.
Urination in a healthy person is an arbitrary act, completely dependent on consciousness. Urination begins as soon as an impulse is given from the central nervous system. Urination that has begun can be arbitrarily interrupted by an appropriate command from the central nervous system.
The physiological volume of the bladder is 250-300 ml, but depending on a number of circumstances (ambient temperature, psycho-emotional state of a person), it can vary widely.
Violations of the act of urination are divided into 2 large groups: a) disorders of the act of urination as symptoms of irritation of the lower urinary tract and b) disorders of the act of urination as symptoms of infravesical obstruction (mechanical obstruction to the outflow of urine at the level of the urethra).
Symptoms of lower urinary tract irritation include frequent and painful urination, sudden onset of an imperative (imperative) urge to urinate (a sudden strong desire to urinate, in which you sometimes fail to hold urine), frequent urination at night. Recently, these symptoms have been referred to as bladder filling phase symptoms. The cause of irritation symptoms is an inflammatory process in the bladder, prostate, and urethra. Tumors, foreign bodies, specific (tuberculous) inflammation, radiation therapy can also cause symptoms of lower urinary tract irritation.
Among the symptoms of irritation of the lower urinary tract, the most common is frequent urination - pollakiuria (daytime pollakiuria - more than 6 times during the day, nocturnal pollakiuria - more than 2 times per night). This symptom appears in diseases of the lower urinary tract: bladder, urethra. The volume of urine for each urination decreases, but the total amount of urine excreted per day does not exceed the norm. The frequency of urination can be significant, reaching 15-20 times a day or more. Pollakiuria may be accompanied by an imperative (imperative) urge to urinate. Pollakiuria can be noted only during the day, disappearing at night and at rest, this often occurs with stones in the bladder. Nocturnal pollakiuria (nocturia) is often observed in patients with prostate tumors. Permanent pollakiuria can be observed in chronic diseases of the bladder. Pollakiuria is often accompanied by pain during urination.
Oligakiuria- abnormally rare urination, most often the result of a violation of the innervation of the bladder at the level of the spinal cord (disease or injury).
nocturia- the predominance of nighttime diuresis over daytime due to an increase in the volume of urine excreted and the frequency of urination. Most often, this condition is observed in cardiovascular insufficiency. The latent edema formed during the day due to heart failure decreases at night when the conditions for cardiac activity improve. The intake of more fluid into the vascular bed leads to an increase in diuresis.
stranguria- Difficulty urinating, combined with frequent urination and pain. Most often, stranguria is observed in patients with a pathological process in the bladder neck and with urethral strictures.
Urinary incontinence- involuntary excretion of urine without the urge to urinate. Distinguish between true urinary incontinence and false. True urinary incontinence occurs in case of insufficiency of the urethral sphincter, while there are no anatomical changes in the urinary tract. True urinary incontinence may be permanent, or it may appear only in certain situations (intense physical activity, coughing, sneezing, laughing, etc.). False urinary incontinence is observed in cases of congenital (exstrophy of the bladder, epispadias, ectopia of the mouth of the ureter into the urethra or vagina) or acquired defects of the ureters, bladder or urethra (traumatic injuries of the urethra and ureter).
Currently, there are several types of true urinary incontinence:
stress urinary incontinence or stress urinary incontinence;
urge urinary incontinence (urinary incontinence) - involuntary loss of urine with a preceding imperative (immediate) urge to urinate;
mixed incontinence - a combination of stress and urge incontinence;
enuresis - any involuntary loss of urine;
nocturnal enuresis - loss of urine during sleep;
persistent urinary incontinence, urinary incontinence from overflow (paradoxical ischuria);
other types of urinary incontinence may be situational, for example, during sexual intercourse, laughter.
Stress incontinence. It develops as a result of a violation of the normal anatomical relationship between the bladder and the urethra due to a decrease in the tone of the pelvic floor muscles and a weakening of the sphincters of the bladder and urethra. At the same time, increased intra-abdominal pressure (laughter, coughing, lifting weights, etc.) affects only the bladder, and the urethra is beyond the action of increased pressure vectors. In this situation, the pressure in the bladder is higher than the intraurethral pressure, which is manifested by the release of urine from the urethra throughout the time until the pressure in the bladder becomes lower than the pressure in the urethra.
Urinary incontinence or urge incontinence- the inability to retain urine in the bladder when there is an urge to urinate. It is more often observed in acute cystitis, diseases of the bladder neck, prostate gland. Urinary incontinence is a manifestation of an overactive bladder.
Nocturnal enuresis- Urinary incontinence that occurs during sleep at night. It is observed in children due to neurotic disorders or intoxication due to an infectious disease, as well as due to the inferiority of the endocrine system, manifested by insufficient production of antidiuretic hormone. Under such unfavorable conditions, dissociation of impulses in the central nervous system occurs and stable connections of the cortex, subcortex and centers of the spinal cord are not formed during the formation of a reflex to urination. As a result, there is insufficient inhibition of the subcortical centers by the cortex at night and the impulses emanating from the bladder when it is filled with urine switch at the level of the spinal cord and lead to an automatic contraction of the bladder with urination, without causing the child to wake up.
Urinary incontinence from overflow. Urinary incontinence from overflow (paradoxical ischuria) occurs due to the loss of the ability of the muscles of the bladder to contract and passive overdistension of the bladder by urine. Overdistension of the bladder leads to stretching of the internal sphincter of the bladder and insufficiency of the external sphincter. In this case, there is no independent urination and urine is almost constantly excreted from the urethra drop by drop due to the excess of intravesical pressure over intraurethral. Urinary incontinence from overflow (paradoxical ischuria) is a manifestation of detrusor decompensation and occurs with infravesical obstruction of any genesis (benign prostatic hyperplasia, urethral stricture).
Symptoms of infravesical obstruction are more often manifested by symptoms of impaired bladder emptying in the form of: difficult onset of urination, the need for straining when urinating; reducing the pressure and diameter of the urine stream; sensations of incomplete emptying of the bladder after urination; acute or chronic urinary retention (involuntary cessation of the physiological emptying of the bladder); intermittent urine output.
Difficulty urinating- noted in cases of obstruction of the outflow of urine through the urethra. The stream of urine becomes lethargic, thin, the pressure of the stream weakens, up to dropping, the duration of urination increases. Difficulty urinating is noted with urethral strictures, benign hyperplasia and prostate cancer.
Urinary retention (ischuria). There are acute and chronic urinary retention. Acute urinary retention occurs suddenly. The patient cannot urinate with intense urge to urinate and intense pain in the bladder area. Acute urinary retention often occurs in cases of existing chronic obstruction of the outflow of urine (benign prostatic hyperplasia, stone and urethral stricture).
Chronic urinary retention develops in patients with a partial obstruction to the outflow of urine in the urethra. In these cases, the bladder is not completely emptied of urine during urination and part of it remains in the bladder (residual urine). In healthy individuals, after urination, no more than 15-20 ml of urine remains in the bladder. With chronic urinary retention, the amount of residual urine increases to 100, 200 ml or more.
The act of urination
The urine formed in the kidneys enters the collecting ducts, from which it enters the small renal calyces, then into the large renal calyces, from which the urine is collected in the pelvis, from which it is excreted through the ureter into the bladder. Where it accumulates before the bladder fills.
With the accumulation of urine in the bladder in an amount of up to 250-300 ml, it begins to noticeably press on the walls of the bladder with a force of 12-15 cm of the water column. This pressure causes the urge to urinate. The nerve impulses that have arisen in the receptors of the walls of the bladder are sent to the center of urination, located in the sacral region of the brain. Signals are sent from this center along the fibers of the parasympathetic pelvic nerves to the walls of the bladder. These signals cause the simultaneous contraction of the muscles of the walls of the bladder and the opening of the sphincters of the urethra. In this case, urine is expelled from the bladder. The higher centers of urination are located in the frontal lobes of the hemispheres big brain, they also regulate the process of urination. Thus, in the bladder, urine acts, by its touch, on the walls of the bladder, irritating the interoreceptors, and through afferent neurons, information enters the CBP, namely, into the frontal lobes, then through the efferent neuron, information enters the working organ - the bladder, and then through the urethra urination occurs.
The emptying of the bladder is carried out unconditionally and conditioned reflex way.
In infants, urination is only an unconditional reflex. The urination reflex occurs in response to irritation of receptors located in the walls of the bladder and responding to an increase in pressure during the accumulation of urine in the bladder. In response to these irritations, the muscles of the bladder contract and the sphincters contract. After 6 years of age, children are taught voluntary regulation of urination (the formation of conditioned reflexes of internal inhibition). The participation of the cerebral cortex in the regulation of the act of urination makes possible a temporary arbitrary retention of urination. At 2-3 years of age, children are usually capable of complete voluntary regulation of urination. At the age of up to 1 year, the number of urination in children is 16-20 times, in 7-13 year olds - 7-8 times a day. The amount of urine produced in children per day is much less than in adults: at the age of one month - about 350 ml, one year - 750 ml, 4-5 years - 1 l, at 10 years -1.5.
The processes of urination and urination in children of primary school age are largely affected by emotional experiences, temperature and humidity.
Characteristics of diseases of the urinary system of preschool children and their prevention at home and in preschool conditions
Urolithiasis begins in childhood as a result of a metabolic disorder. One of the most common symptoms is the excretion of large amounts of salt crystals in the urine. Sometimes the color of urine changes to orange, boil-red or brown. Urolithiasis in children may not appear outwardly or cause discomfort when urinating. It can be identified through analysis. Preventing the appearance of salts in the urine of a child is simple. The most important thing is to drink plenty of water and follow a certain diet.
Enuresis. In infancy, urination occurs involuntarily. With age, conditioned reflexes are formed and fixed, providing arbitrary urination. However, some children, mostly boys, have bedwetting - enuresis. The cause of this disease may be the wrong mode of life of the child - food before bedtime, an abundance of fluids, abnormal sleep, spicy food, as well as inflammatory processes in the bladder or kidney disease. Often, enuresis occurs in children as a result of neuropsychic shocks, such as conflicts in the family, fear, acute pain, etc. etc. Surrounding people do not always understand that bedwetting is not promiscuity, not laziness, but a disease. Therefore, such children are shamed, punished, which provokes the disease even more because of the pressure on the child and his psyche. That is why parents and educators should show special sensitivity to a child suffering from enuresis, parents should consult a doctor who will prescribe the necessary treatment. Enuresis usually resolves in children by the age of 10 or during puberty. The first stage of treatment is careful observation of the child.
Pyelonephritis - inflammatory disease kidneys and renal pelvis. Pyelonephritis can be acute and chronic. The disease is caused by a nonspecific microbial infection that has penetrated the kidney and pelvis in a descending or ascending way. Pyelonephritis can occur in many acute infectious diseases. There is a strong chill, the temperature can rise to 40 degrees, there is pain in the lower back, nausea, vomiting, headaches and muscle pain. Treatment: antibiotics, bed rest, plenty of fluids, also diuretics of plant origin (cowberry leaf, cranberry, juniper, horsetail), drinking mineral water, thermal procedures on the lower back. And, of course, see a doctor.
Diffuse glomerulonephritis is an infectious-allergic disease of the kidneys, more common in children from 3 to 12 years old. The main symptoms are: swelling, increased blood pressure. Treatment should be carried out only in a hospital setting. Strict bed rest and a special diet are prescribed. The earlier the diagnosis is made and treatment is prescribed, the more favorable the prognosis and the sooner the child will recover.
Cystitis is a microbial-inflammatory process in the wall of the bladder (usually in the mucous and submucosal layer). In children, cystitis can be suspected if there is frequent urination (at least 2-3 times per hour), the appearance of pain in the lower abdomen, as well as in the perineum and rectum, turbidity in silence and fever. Urinary incontinence can also be a wake-up call. In girls, compared with boys, the risk of "earning" cystitis is 5-6 times higher. The reason for this phenomenon is the anatomical features of the genitourinary system of girls: a short and wide urethra, which is close to the vagina and rectum. Treatment: bed rest, taking medications, sitting baths on herbs (sage, chamomile, calendula), dry non-hot heating pad (up to 38 degrees).
Vulvovaginitis is an inflammation of the walls of the vagina and vulva in girls. Symptoms of vulvovaginitis are itching and burning in the genital area. The main threat in vulvovaginitis in girls is the fusion of the labia minora, which, when neglected, can lead to the closure of the urinary canal. Treatment should be carried out with the help of a gynecologist, self-treatment is unacceptable. Sometimes it happens that this inflammation, which has arisen due to poor hygiene, can be cured with regular washing and compliance with the hygiene standards of the body and genitals. However, this does not always happen, and it is necessary to consult a specialist. The doctor prescribes antibacterial and antifungal agents, as well as a special diet.
Some diseases can be prevented by observing the rules of personal hygiene and hygiene of the genitals.
First, it is necessary to wash the child daily in the shower using baby soap.
Secondly, every day, and tame the elders yourself, change your underwear.
Thirdly, make sure that children do not have worms.
Fourthly, it is necessary to temper the child, because the stronger the immunity, the less the risk of disease.
Thus, the organs of the urinary system are closely connected with the genitals, therefore, hygiene skills in caring for the skin of the external genital organs and perineum should be instilled in the child from the first days of life, which eliminates the unpleasant odor, which especially increases during puberty.
