15.11.2017 · 👁 2,718
Pain in diseases of the genitourinary system
Pain in diseases of the genitourinary system can be acute, in the form of an attack of renal colic, or dull, which is constant or aching in nature. Sometimes a dull pain alternates with an acute attack and is the main manifestation of the disease. Often it is absent or weakly expressed with other obvious signs of the disease.
The localization of pain usually corresponds to the location of the affected organ: in the lower back or hypochondrium - with kidney disease, in the lower abdomen above the pubis - with bladder disease, in the anus, perineum, above the pubis, in the sacrum, inguinal areas - with damage to the prostate gland, in the urethra in the form of itching, burning, intensifying at the time of urination - with inflammation of the urethra. However, in some cases, pain is felt not only in the area of the affected organ, but is also transmitted, radiating, to nearby areas. Determining the nature and localization of pain greatly facilitates the establishment of a topical diagnosis. Thus, with diseases of the upper urinary tract, pain can radiate along the ureter, to the groin area, testicle or labia, inner thighs, and occasionally to the anus; with stones or foreign bodies in the bladder, the pain radiates to the head of the penis, which is especially pronounced when walking or urinating.
Acute pain (renal colic) is caused by a sudden disruption of the outflow of urine from the calyceal system of the kidney, leading to overflow of the pelvis and, accordingly, the calyces with urine, overstretching of the fibrous capsule, and impaired lymph and blood circulation in the organ. It is the result of acute irritation of sensitive nerve endings, which are richly supplied in the fibrous capsule of the kidney, the wall of the calyces and the pelvis. Typically, such an acute disturbance of the outflow of urine can occur with a sudden blockage of the ureter or ureteropelvic segment with a stone (more often), less often with a blood clot or pus and mucus, an accumulation of salts, or tumor fragments.
An attack of renal colic occurs suddenly and can last several minutes, hours or days. It is characterized by acute pain in the lower back or hypochondrium with irradiation along the ureter to the groin, bladder, and external genitalia. An attack may be accompanied by frequent urination or a painful urge to urinate, often bloating, nausea, and vomiting. These symptoms of peritoneal irritation are explained by anastomoses of the renal nerve plexus with the solar and celiac plexus and often require differentiating renal colic from appendicitis or intestinal obstruction. Patients behave restlessly and often change position. Body temperature is normal or subfebrile. Usually, microscopy reveals red blood cells in the urine (microhematuria), and occasionally the urine is stained with blood (macrohematuria). Clinical manifestations of renal colic may be accompanied by increased body temperature, chills, leukocytosis, accelerated ESR, azotemia, which is associated with the reflux of urine (reflux) from the overstretched pelvis into the kidney parenchyma and blood. In most cases, body temperature and blood counts return to normal as urine flow is restored and colic subsides.
Dull, one-sided, aching pain in the lower back is also caused by a slowly developing disturbance in the outflow of urine from the kidney, overstretching of the collecting system, an increase in the volume of the organ, and irritation of the nerve endings of the capsule. It is observed with stenosis of the ureteropelvic segment, stone of the pelvis or ureter, tumor of the ureter or bladder, prostate cancer, compression of the ureter by a tumor coming from a nearby organ.
Pain in the bladder area is usually associated with urination. It can occur at the moment of inflammation or be constant above the pubis with bladder cancer (stone) and intensify at the end of urination.
Pain above the pubis, in the perineum, groin areas, and sacrum is often associated with inflammation, less often with a tumor of the prostate gland.
The pain in the urethra is acute, cutting in case of acute inflammation and accompanied by itching, tickling, burning in chronic inflammation. It is usually associated with the act of urination, but can be independent, outside of it.
Pain in the testicle or epididymis is usually the result of inflammation of these organs.
Do not tolerate pain and contact a doctor immediately. And for any questions you may have, please call: +(998 71) 140-03-03, +(998 71) 140-01-60. We remind you that the Urologic Complex clinic is located at Chilanzar, block 12, st. M. Shaykhzoda, 7