Pollakiuria

POLLAKIURIA, pollakiuria (from Greek pollakis- often and ouron- urine), synonym for turyuria, frequent urination, a symptom of the most diverse pathological conditions. The basis of P. as a rule lies in increased sensitivity of the walls of the bladder. Most often this increased sensitivity is caused by various inflammatory processes in the bladder (when it is infected, when its mucous membrane is irritated by various abnormal components of urine, etc.), especially if these inflammatory processes are localized in the area of the posterior urethra or bladder neck and if they penetrate deep into the mucous membrane and lead to the formation of ulcers. Simple hyperemia of the bladder mucous membrane on the basis of circulatory disorders in the bladder itself or in its vicinity (e.g., in case of blood stagnation in the seminal vesicles, prostate with pressure on trigonum Lieutaudi, sometimes in hemorrhoids, constipation), trauma to the mucous membrane by a stone present in the bladder can also lead to P. Furthermore, P. can be caused by various reflex effects on the bladder musculature (P. in the cold, with reflexes from other organs, in particular from the kidneys, e.g., in tbc of them, and from the ureter, with chronic inflammation of its pelvic end or with a stone in the ureter), as well as weakening or even complete disappearance of inhibitory urination impulses from the brain on the basis of functional (e.g., in strong excitement, emotional experiences, neurasthenia, hysteria) or organic (e.g., sometimes in tabes dorsalis) diseases of the nervous system, in particular in lesions of the diencephalon. Decrease in bladder capacity with various processes both in it itself (inflammatory processes, especially those leading to shrinkage of the bladder, malignant and to a lesser degree benign neoplasms in it, etc.), and in neighboring organs [e.g., pressure on the bladder from the uterus in its incorrect positions, prolapse or descent (see Prolapse of uterus, vagina, Uterus)], retention of urine due to difficult urination (in prostate hypertrophy, narrowing of the urethra), when the bladder is overstretched and when the arrival of relatively small new portions of urine is already sufficient to cause the urge to urinate, can also cause P. Finally, P. can develop in all diseases accompanied by polyuria (in particular in nephrosclerosis, diabetes insipidus and diabetes mellitus, in the resolution of cardiac and edemas). In P. of the latter type, the daily amount of excreted urine is significantly higher than normal, which is usually not observed in other types of P. The number of urinations in P. instead of the normal 4-6 per day, which also occur during daytime hours, can increase to an incredible frequency with minute-by-minute urges (e.g., in tbc of the kidneys and bladder), turning the patient into a complete invalid. The nature of the urine - normal or pathological - is determined by the nature of the process causing pollakiuria. P. finally can be observed as a physiological phenomenon. It often manifests in the initial stage of pregnancy and some women on the basis of P. alone assume they are pregnant. Clinically, P. has the significance that its appearance, if P. begins to have a more or less prolonged character, is always a pathological phenomenon, sometimes already appearing at the very beginning of the disease (e.g., in cystitis, tbc of the kidneys); the intensity of P., as well as the increase or decrease in its degree, sometimes (e.g., in bladder diseases) is a good indicator of the intensity of the pathological process causing it, its worsening or improvement. The nature of P. can be an important differential diagnostic sign in recognizing the disease causing P.; in particular, one should consider: whether there is an intensification of P. with movement (e.g., with stones in the bladder and ureter) or with bed rest (e.g., in prostate hypertrophy); how urinations are distributed throughout the day (exclusively daytime P. in neuroses, more often daytime in stones, predominantly nocturnal - especially in the first 2-3 night hours - in prostate hypertrophy, predominantly nocturnal P. during the period of edema resolution in cardiac patients, more or less evenly distributed throughout the day P. in diabetes, etc.); whether there is pain during urination (almost always present in bladder lesions), what is the nature of the urge to urinate, the nature of the urine, etc. In diagnosing the disease causing P., in addition to a thorough history, examination of urine and urogenital organs, attention should also be paid to the condition of organs adjacent to the bladder, as well as the heart, nervous system and endocrine apparatus. - Treatment of pollakiuria is determined by the underlying disease.