1.What is oliguria, anuria and polyuria Under normal circumstances, each person excretes about 1500-2000ml of urine a day. if the amount of urine in 24 hours is less than 400ml, it is called oliguria, and less than 100ml is called anuria. If the volume of urine in 24 hours exceeds 2500ml, it is called polyuria. 2.How to correctly analyze the causes of oliguria and polyuria Oliguria can be caused by various physiological or pathological factors, such as diarrhea, vomiting, peritonitis, etc., which can cause dehydration and thus insufficient effective circulating blood volume, as well as damage to the renal parenchyma, urinary tract obstruction, acute tubular necrosis, etc., which can also cause oliguria and should be noted when analyzing the causes of oliguria. Renal polyuria occurs for different reasons, but more commonly occurs in chronic renal insufficiency, which is due to renal tubular insufficiency, resulting in decreased urinary concentration. Once the symptoms of polyuria appear, it often indicates that the kidney function has been impaired, and the specific gravity of the urine is mostly persistent low specific gravity urine. If it occurs during the polyuric phase of acute nephritis or acute renal failure, it often indicates that the condition is reduced or tends to improve. In patients with chronic interstitial kidney or tubular acidosis, polyuria is also often present due to tubular damage. The occurrence of renal polyuria is often mechanistically interconnected with polyuria due to other systemic diseases and is difficult to distinguish absolutely. For example, in primary aldosteronism, polyuria can be caused by high sodium stimulation of the hypothalamic volume center, or it can be caused by low potassium tubular damage resulting in reduced concentration function. 3, what is nocturnal polyuria In general, the daytime urine volume of a normal person should be greater than the nighttime urine volume. In young people, the ratio of daytime urine volume (6am-6pm) to nighttime urine volume (6pm-6am) should be 2:1. The ratio decreases with age and may drop to 1:1 by the age of 60. If the nighttime urine volume exceeds 1/2 of the daytime urine volume, it is called nocturia. 4, what are the common causes of increased nocturnal urination Under normal circumstances, after dinner generally do not drink much water, but also rarely eat, and in the body after sleep metabolism will also be reduced, so the blood flow is slow, the flow through the renal tubules of the original urine can be fully reabsorbed back into the circulatory system, so the total amount of nocturnal urine should be significantly less than the amount of urine during the day. In some cases, this can also lead to an increase in nocturia, and the common causes are: in renal insufficiency, as the disease continues to progress, the number of viable kidney units decreases, so metabolic waste is retained in the body, causing the residual kidney units to work continuously around the clock, which manifests as an increase in nocturia; in the presence of tubulointerstitial lesions, the concentration function of the kidney decreases, so the early stage of the lesion will also In the presence of interstitial renal tubular lesions, nocturia is also increased in the early stage of the lesion because of the decrease in the concentration function of the kidneys, which is manifested as an increase in nocturia; others, such as voiding nocturia, occur when there is water retention in the organism, such as in the case of functional insufficiency, and after lying in bed at night, the blood circulation of the kidneys is improved, which increases the blood flow supply to the kidneys and facilitates the discharge of the retained water in the organism, which is manifested as an increase in nocturia; in patients with mental stress (such as those with long-term enuresis), nocturia often occurs, which is called In patients with mental stress (such as long-term enuresis), nocturia often occurs, which is called preventive urination, and after a long time, it will form a habit, that is, mental nocturia. 5, what is urinary incontinence urine in the bladder can not be controlled and out of their own, called urinary incontinence. It can be divided into two categories: true incontinence and pseudo-incontinence. True incontinence mainly includes two types. Active true incontinence refers to the loss of subjective control of urine as a result of a tonic contraction of the detrusor muscle, which causes urine to overcome the contraction of the sphincter muscle and drip out, and the bladder is often empty. Passive true incontinence is caused by damage to the sphincter, paralysis, or the presence of an abnormal fistula that causes the urine to drip out uncontrollably. If the bladder is often in a state of overfilling and the resulting urine is constantly dripping out, it is called pseudo-incontinence, also known as filling incontinence. 6, what are the common causes of urinary incontinence The common causes of true incontinence include severe cystitis, tuberculous cystitis and infantile enuresis, etc. Certain neurological diseases that lead to bladder spasms such as multiple sclerosis (Multiple Sclerosis) can also be manifested as this type of incontinence. Common causes of passive true urinary incontinence include uterine prolapse, abnormal bladder neck motility, urethral sphincter injury due to childbirth, excessive urethral dilatation, post prostate removal, umbilical ureteral fistula, and ectopic ureteral opening. Most of the common clinical cases of stress urinary incontinence in menstruating women are in this category. The urethral sphincter itself is not abnormally damaged in patients with filling incontinence, but is commonly associated with urethral obstruction due to various diseases, such as prostatic hyperplasia, urethral stricture, neurogenic lesions such as spinal consumption, and also in the early spinal shock phase of spinal injury. 7.What is urinary retention Urinary retention means that urine is in the bladder and cannot be discharged normally. According to the characteristics of the history of urinary retention, it is divided into two categories: acute urinary retention and chronic urinary retention. Common causes are urinary obstruction below the level of the bladder due to various reasons, such as inflammation of the urethra, urethral stones, tumors, prostate hypertrophy, and fibrosis at the bladder opening. In addition, neurogenic bladder caused by spinal cord injury is also a common cause of chronic urinary retention. When diagnosing different etiologies, attention should be paid to the differential diagnosis based on the characteristics of different diseases. In the presence of urethral disorders, there is often painful spasm of the urethra during urination; in the case of prostate disorders, the resulting urinary disorders are often progressive; in the case of bladder disorders, there are usually symptoms of bladder irritation such as frequency, urgency, and painful urination; and in the case of stone disorders, the symptoms of interruption of urinary flow during urination may be relieved by changing position or jumping. Cystourethrography and cystourethroscopy can be helpful in determining urethral injury and bladder disorders. In contrast, neurological examination and urodynamic examination and electromyography have diagnostic value for the diagnosis of neurogenic bladder. 8.What are bladder irritation symptoms Bladder irritation symptoms refer to urinary frequency, urinary urgency and painful urination. If the number of urination is abnormally increased is called frequent urination, if there is a sense of urgency in urination is called urgent urination, and if you feel pain when urinating is called painful urination. In general, normal people urinate 3 to 5 times during the day and 0 to 2 times at night. The number of daytime urination also varies with the amount of water consumed, the climate and personal habits, but the number of nighttime urination is generally more constant, so the clinical significance of the increased number of nighttime urination is greater. The most common cause of bladder irritation symptoms is nonspecific cystitis. In addition, urinary tuberculosis, bladder stones, tumors, foreign bodies, prostatic hyperplasia, lower urinary tract obstruction, prostatitis, and vesiculitis can all manifest as bladder irritation symptoms. 9, What is Urethral Syndrome Urethral syndrome (Urethral Syndrome) is a common lower urinary tract symptom in women, manifested as obvious urinary frequency, urinary urgency, urinary pain and urinary tract irritation symptoms such as difficult urination, but generally no systemic manifestations, no lumbago, no pressure pain without upper ureteral point, rib and lumbar point, no percussion pain in the kidney area. Laboratory examination of the middle urinalysis leukocyte count is not increased or slightly increased, usually <10/HP, repeated urine bacterial culture colony count <10×107/L (105/ml), symptoms can mostly disappear gradually after 2-3 days, but recurrence is easy to occur, the etiology of the syndrome is unclear, part of which may be caused by pathogenic infections, and another part may be caused by non-infectious diseases. 10, what are the characteristics of each of the pain of the urinary organs Pain is a common symptom of urinary and male genital disorders. Clinically, in order to make a clear diagnosis, attention should be paid to detailed history taking and physical examination. First of all, we should ask about the location, nature and degree of pain, whether there is radiating pain, where it radiates to, and whether there are other accompanying symptoms. Kidney disorders can cause low back pain or epigastric pain, which can be manifested as hidden dull pain or distension (such as tumor, hydronephrosis, kidney stone, etc.), or sharp sharp sharp pain or colic (such as acute purulent infection of kidney or perinephric; advanced kidney tumor in which the tumor tissue invades the nerve root near the renal hilum; acute renal tibial torsion occurring in cases such as wandering kidney, etc.). Colic is commonly associated with spasm caused by acute renal pelvis and ureteral obstruction due to various diseases. If a stone or blood clot moves down the ureter, it can cause severe colic, and the pain can radiate to the lower abdomen, perineum, inner thighs, etc. It is clinically known as renal colic. Another kind of pain in the kidney area is reflex pain, where the kidney itself does not have any disease, but is reflected from other parts (such as prostate disorders, vulvar disorders, female pelvic organ disorders, etc.). In addition, a kidney disorder on one side can also cause pain in the opposite kidney area through the kidney-renal reflex. Pain symptoms due to bladder disorders are usually confined to the suprapubic area and are usually vague or distending in nature, and can be caused by inflammation, stones, obstruction, or overstretching of the bladder. However, severe pain can also be caused when inflammation of the bladder reaches the submucosa or muscle layer of the bladder wall (e.g., interstitial cystitis, severe tuberculous cystitis, etc.). In addition, advanced bladder tumors or tumors near the urethral orifice, in addition to severe pain and discomfort, are often combined with urinary frequency, urinary urgency and difficulty in urination, and sometimes the pain can radiate to the head of the penis. Urethra, prostate, seminal vesicles and other organs often have different characteristics of pain symptoms due to the presence of acute and chronic inflammation, stones, urethral strictures, prostatitis and seminal vesiculitis. In general, the localization of pain in the urethra is relatively clear, while the site of pain in the prostate and seminal vesicles is often less clear and may have radiating pain. Acute and chronic inflammation of the testis, trauma, tumor, torsion and varicocele often lead to painful symptoms in the testis and nearby areas. Acute epididymitis, orchitis, acute testicular torsion, trauma, etc. usually lead to severe pain, while the swelling and discomfort caused by varicocele is not very serious, and testicular tumors usually do not show painful symptoms in the early stage.