On 10 18 ,   4 27 , billsahi...@yahoo.com wrote:

Urethra syndrome etiology

Although the cause of the syndrome has not yet all clear, but the
current study showed that the major reasons with the following.
(1) The spirit of the reasons (mental) causes about 100 years ago
already know mental excitement may affect bladder pressure and bladder
contraction, people often realize that mental tension and frequent
urination a short time. Straub made by the other in 1949 in the spirit
of tension bladder pressure measurement, anxiety can cause bladder
Overactivity (unknown detrusor hyperreflexia). Although the levy
people easily think of lower urinary tract infection or inflammation,
but the spirit of the reasons for this view interpret these symptoms
and lower urinary tract infection caused by the different symptoms,
former symptoms lasted for a long time, and the magnitude of change
often, the symptoms occurred mainly in the daytime, and accompanied
suprapubic and low back pain, nausea, constipation, fatigue not easy.
Spirit of factors can affect the abnormal urination is another
evidence can cause urinary retention, our data shows During World War
II, soldiers see the spirit of bladder dysfunction. Why is there will
be various forms of mental stimulation frequent urination, urgent
urination and urinary retention two types of reaction is unclear. But
aware of the cerebral cortex in the frontal area of detrusor on the
Central. The subcortical limbic system and the emotional expression of
the most closely, the limbic system, including the hippocampus, the
cingulate gyrus and the amygdala. and efferent fibers project to the
hypothalamus, the brain. Animal experiments, electrical stimulation
almond approved lowering the threshold urination, and electrical
stimulation of the brain mesh structure, pons, medullary can cause
detrusor contraction, but the site for partial resection of bladder
causing no reflection, So detrusor vulnerable to the more senior
center from the excitatory and inhibitory impulses impulses, These
higher from the central nerve impulses is also the mental urination
influence of the media. In general, frequent urination and urgent
urination syndrome usually related to anxiety, spirit and urinary
retention in mice found more hysteria and emotional depression
patients.
Rees 1971 with other psychological testing to 50 cases of urinary
tract syndrome patients, the study found. 30% of patients with urinary
symptoms before have anxiety or depression, 60% of the patients
receiving treatment through the psychological tests showed they are in
clinical anxiety and depression, the general population is only 6%. In
this group of patients the average follow-up of 21.4 months, 50
patients of 39 patients (78%) with psychotherapy alone completely
cured. Minnesota used a number of personal questionnaire (MMPI), in
the majority of patients were found in a special psychological
barrier, in these patients suspected disease, Hysterical and
schizophrenia Scale score higher than an age group and gender matching
the "medical patient" control group. the author of 15 patients by
psychotherapy (psychiatric counseling) 13 symptoms disappear
completely. But the spirit of factors have opposing views.
Summersl992, reported on 58 cases of patients with U.S. and 44 cases
of urinary tract infection in patients with the clinical psychological
assessment, results showed that the spirit of the two groups have a
high depression score, U.S. patients and the control group are
incomparably higher the incidence of mental illness. All large-scale,
systematic psychological assessment will be convincing evidence.
(2) Neutrogena causes in women, as for the very simple urethral
inspection or gently squeezed after transurethral have a small amount
of bacteria into the bladder. Buckley confirmed as 1978, 55% of women,
urine can make sexual intercourse with a transient increase in
bacterial counts, generally after 48 hours bacteria counts to normal,
but none developed symptoms. This raises the question of why some
women from urinary symptoms and most women do not occur. Many scholars
hold that the sphincter spasm caused turbulence within the urethra,
thereby increasing the bacteria Chong back to the possibility of the
bladder. While the majority of women can effectively voiding, the
bacteria limit the distal urethra. Germs can not invasive bladder or
reproduction prior to the removal. Outside spastic sphincter may be
emotional or long-term abnormal urination habits lead to the process
of voiding urethral opening mechanism with bereavement missing, in
most cases even if the patient had no urinary tract infection such
sphincter spasm can cause urinary tract syndrome. Many patients can
alleviate urination stated urethral or vaginal entrance limitations do
not apply, this means that the urethral sphincter relaxation can
relieve symptoms; some patients with the same performance urination
forced to balk, dripping Lek or stop, this also shows that there
sphincter completely or partially relax the sphincter malfunction.
When the stream flow measurement is extended or interrupted, pressure
on the urethra or percutaneous electrode measurements revealed that
urethral sphincter tension. Drugs such as Diazepam with biofeedback or
electrical stimulation treatment effect could support the hypothesis.
Price said urethra nerve branch was thickened fibrous tissue
surrounding the nerves leading to abnormal reflex, and has gradually
formed U.S... Fibrosis can be injury, infection, X-ray irradiation.
(3) infection of the urethra syndrome infection is to study the role
of the earliest and largest. The majority of those who support this
view for two reasons explain why clinical practice tests on the seized
not see the original infection. First, urinary tract infection in the
patient's urine disease bacteria often less than 105/ml; Second, hard
cultured microbes often emigrated urinary tract, urine samples need
special collection, training, and incubation and technology can test.
Lower urinary tract microbes are places of abode and symptoms of many
women, VB1 and VB2 in the ban, which is running the ball (WBC> 5/HPF)
therefore lack the necessary diagnosis of urethral syndrome the
objective should be found. Rammstein, etc. (1979) and Wilkins, etc.
(1989) reported up to 1 / 3 of the female urethra under Habitat is
difficult places cultured microbes, such microbes are considered to
stimulate urination symptoms caused no cyst. These microorganisms
mainly refers Lactobacillus and Streptococcus, Diphtheria bacilli,
pathogens are conditions. But some scholars of US patients with normal
urine of microorganisms such a comparison, there is no difference in
volume; another treatment with antibiotics such sensitive U.S.
patients void, which indicates infection was not the direct cause of
U.S... Another urethral syndrome is believed inflammatory or
infectious cause of the reasons is seen within endoscopes, as
urethritis pseudo-like triangular bladder inflammation, urethra and
bladder stones kind of triangle (brief), and erythema. But these
changes can also be interpreted as artificial hormones or trauma,
Besides these findings is not always associated with urethral
syndrome, and not all of bacteriuria these patients are found, and
after consultation with the Mirror handling or treatment efficacy at
best, its success is sometimes reduce or mitigate the symptoms only,
Finally, the treatment of symptoms even from the perspective of
effective treatment, but with no consultation microscopy lesions
disappeared evidence. Therefore urethral syndrome from the inside out
in consultation found to support the STD original view was that the
evidence was not sufficient.
(4) Urethral outside factors :
1. Urethra from the outside I nearly vaginal mouth : outside the
normal female urethra oval-shaped mouth, vagina and mouth a certain
distance, the adult is about O. About 5cm. HE Huixu so by observing
372 women outside the urethra I mentioned just now placed outside the
urethra confirmed distance from the mouth of vaginal mouth more
comprehensive nearly urethral the higher prevalence rate of the levy,
3mm spacing below the prevalence rate increased significantly. Cao
Yuguang, Zhang Shuang (1995) reported 1,006 cases of female urethral
surveys found outside the urethra from the outside I   vaginal mouth
distance from 3mm for urethral syndrome 72.15%, and the shorter the
distance the higher the prevalence rate. That is a short distance from
urethral syndrome induced by the important factors, The reason is that
sexual intercourse outside the urethra when I was squeezed into the
vagina and susceptible to injury and vaginal secretions into the
urethra easy countercurrent caused.
2. Urethra obstruction:
1) The lack of anomalies : normal female urethra hymenal ring outside
the mouth at the bottom, which for vaginal vestibule. Cao Yuguang,
Zhang Shuang (1995), the study found outside the normal mouth-disease
rate was only 1.66%, and type dam, hymen umbrella, Hymen-prevalence
rate of 86.95%, 80%, 79.54%. The dam is due to urethral - mouth
outside the rear left hymen scar hypertrophy its basement, forming
dams seems like uplift. Hymen umbrella over hymen is hypertrophy,
could create a large sheet film, like an umbrella to the front opened,
I covered urethra, secretions from impact and voiding urine can be
formed from the mouth of urethral reflux. Besides the above two types
can be found in the distal urethra mouth formed outside pocket
lacunae, As part of urine and secretions easy to pulsate within the
lacunae in the local stimulate so, resulting in the emergence of
urethral syndrome. Hymen - urethra is located outside the mouth hymen
rings, each sex has caused pain, prone hymen periarthritis, due to
lack of vestibular, intercourse will urethral passage of the vagina to
mouth, its incidence of urethral and other reasons I mentioned just
now placed in the same short distance.
2) partial urethral orifice pathological changes : Cao Yuguang, Zhang
Shuang (1995), partial visible pathological changes of high
prevalence, such as transurethral Caruncle, mucosa prolapse were 4 /
5, 6 / 8 (due to less number of cases is not the percentage
statistics). The incidence of this type because both infection and
obstruction of a combination of factors.
3) distal urethral tissue around : women 1cm without distal urethral
muscle, Only two to three layers by fibrous tissue surrounding the
urethra, the termination of the smooth muscle on the annulus fibrosus.
If this part of the collagen fibers are too rich, the lack of
flexibility, will the distal urethra caused surrounding tissue
fibrosis caused distal urethral stricture. Many scholars claim that
using surgical methods such as dilatation, excision and incision
surgery, such as transurethral widened with good results,
Unfortunately, the lack of coverage all of the diagnostic criteria;
Furthermore, some operations run the risk of incontinence and efficacy
of uncertainty, often temporary, is more important anatomical
obstruction causes no supporting evidence. Currently histological
study of this increase did not agree with fibrosis, and the samples
could not explain the error, so we can not accept compulsory. Other
Duke Medical School reported 63 cases of female urethral syndrome
patients were found to have only one cases of urethral stricture,
therefore, urinary tract obstruction may cause urethral syndrome, but
do not think urethral syndrome is a common cause.
(5) Female "prostatitis" theory female urethral syndrome the same
symptoms in men are considered prostatitis. Male patients often have
ineffective treatment with antibiotics, urology clinic often these
long-term urinary symptoms, but anal palpation to check the prostate
in a "swamp-like (boggy)" prostate liquid bacteriological examination
is usually negative situation from chronic prostatitis or aseptic
prostatitis, also known as the prostate or prostate pain syndrome. So
far very few people infected with the anatomy of the urethra hidden
side of the gland. beside urethral gland (Skene gland) urethral
orifice openings in the mucosa (the other urethral mucosa has many
small urethral gland. urethra openings in the mucosal surface). There
is evidence that the gap before the vagina, urethral distal 1 / 3 of
the adjacent urethral gland from under the microscope observation of
the prostate homology, understand now distal urethral carcinoma is a
rare female "prostate" of the original cancer, they could be specific
staining and the PSA prostate specific acid phosphatase staining
color. Since the brain-dead donor collection to the female urethra and
around all the soft tissues, series of horizontal and vertical
sections can be found beside urethral gland, and PSA was positive.
Right on both sides of the urethra anterior vaginal tissue for point-
palpation can be found limitations tenderness. Tenderness urethral
gland next to the treatment of men with prostate infection of the same
treatment. First, the urinary concentration of antibiotic treatment
with urethral gland and adjacent to its internal unrelated to any
microbes, organizations need to be able to access the drugs; second,
beside the urethral gland not affected and lively might need access to
organizations of antibiotics for a prolonged period of treatment
before can cure, but in a few months or a few years later may relapse,
referring to the attending tenderness there. Such patients NA urethral
dilation, or anti-anxiety medication.
(6) estrogen levels decline female urethra and bladder triangle of
estrogen receptor content with the same vagina, in postmenopausal
women bladder, urethra and genitalia are the same shrinkage change.
Around the urethra and bladder neck glands and the catheters, urethral
mucosa and submucosal tissue shrinkage thinning. Change urethral
smooth muscle flexibility with the ratio of fibrous tissue, so
urethral muscle by rich stretch of the pipeline become uncoordinated
pipeline and voiding variable width can not be shortened. In addition
to the urethra so E2 alpha-receptor stimulation weakened, urethra and
diastolic function and significantly diminish tension urethra, so
urethral pressure drop interference urethra and bladder coordinating
role trigger instability bladder. Along with the increase of age,
bladder capacity diminishing trend, the slow urination, increased
residual urine. According to the survey 70% of older women Niaopinkang
night, and older men is 50% Of course, this also with the elderly and
spinal reflex weakened central cortex of the bladder weakening of the
control. As another elderly female vagina, urethra and genital
vestibular tissue shrinkage, epithelial keratosis organizations
reduced glycogen content decreased, urethra and the vaginal mucosa
only outside the bottom and bottom cells, the lack of urethral
secretions surface, the role of its Self-cleaning lower easy bacteria
in the vagina, urethra and vestibular breeding and become senile
vaginitis and urinary tract infection causes. Some scholars believe
that the female hormone shortage could transurethral collagen fibers
around hyperplasia, urethral obstruction occurred. Cao Ning hygiene
(1995) noted that there are women of childbearing age E2, the problem
of inadequate and such patients urodynamic performance of lower
urinary tract dysfunction, it reduces the level of estrogen should be
considered one of the factors for the disease.
(7) Other
1). Immune factor : Some people found that most cases of urinary tract
syndrome have IgM deposition, the positive immunofluorescence and
clinical symptoms are closely related to the severity (P <0.0001), it
is felt that the female urethral syndrome may prevent bacteria from
sticking to the bladder mucosa-glucan (GAG) by the protective layer
damage to make urine and other possible violations of pathogens can be
organized under mucosa caused inflammatory response. Stimulate the
immune response is mainly IgA. Witherowl989 reported in patients with
bladder mucosa U.S. vascular proliferation immunofluorescence showed
vascular wall are antigen-antibody complex deposition.
2). Lack of magnesium ions : Montgometry so that the increase in
extracellular Mg ion concentration, can vitro bladder detrusor muscle
silk elongation, inhibit calcium flow, reduce muscle excitability.
Lack of magnesium and cause increased excitability detrusor, bladder
compliance poor, which are the cause of instability of the bladder
factors.
3). Iatrogenic : urethral syndrome because of complex etiology,
diagnosis is very tedious, some urology doctors or did not realize
this syndrome, or because of some other reasons, such as the case
load, diagnosis and treatment is cumbersome and uncertain effect
hastily attributed to its urinary infection, precious long-term
antibiotic use and no obvious symptoms of patients to improve the
economic burden will increase with the spirit of burden so doctors
urinary syndrome more specific cause of each patient, less under the
diagnosis of urinary tract infection; for more patiently explained,
using less expensive antibiotics is very important. Considering that
the syndrome have a high rate of natural ease, at least for iatrogenic
factors protracted illness bears some responsibility.
In short female urethral syndrome causes of the current combination of
the above should be considered comprehensively, but also said many
more appropriate because, a possible as a predisposing factor. for
lack of timely and correct treatment of a variety of factors involved
in making and closely related disorders as a result of performance or
a vicious circle, so persistent symptoms, and insubstantial. U.S.
diagnosis is complicated by the exclusion, doctors now is the
syndrome's own knowledge and experience to choose treatment, This
requires doctors to this syndrome of the current study is a
comprehensive understanding, but also a strong sense of
responsibility. spend some time on the patient and patient
explanations, and the treatment of serious follow-up, these measures
proved to be necessary and effective.

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Bladder_calculi_etiology_133.html