Urinary syncope, also known as sudden urinary collapse, is mainly due to hypotension caused by impaired vasodilation and contraction, resulting in a momentary lack of blood supply to the brain.
I. Analysis
1, due to a sudden change in position or excessive force during urination.
2.Sudden emptying of the bladder and sudden decrease in intra-abdominal pressure.
3, reflexively caused by a drop in blood pressure, temporary ischemia of the brain.
4.Phytodystrophy, more common in the elderly.
II. Characteristics
1.It occurs mostly during or at the end of urination, with dizziness, blurred vision, and weakness before the onset.
2. Sudden loss of consciousness for 1 to 2 minutes and simultaneous fainting, prone to trauma. Those who wake up naturally do not leave after-effects.
First aid
1. Prevention is the main concern, and those who have a history of this disease should be supported.
2. If you are dizzy, lie down on the ground and keep your head down.
3.Keep warm, prevent cold and frostbite.
4.In case of bradycardia, inject atropine subcutaneously.
Prevention
1, usually go to the hospital to investigate the cause and treatment.
2.When you get up to urinate during sleep, move slowly and do not get up suddenly.
3.Do not urinate too quickly or too forcefully when urinating. It is best to urinate in a squatting position or in a side-lying position with a commode to prevent injuries from falling and bruising.
4, plant nerve dysfunction, can take oral glutamate 10-20mg / time, 3 times / day, for several days.
Clinical manifestations
The disease occurs mostly in men aged 16-45 years, and occasionally seen in the elderly. Patients often faint suddenly in the early morning, at night or after a nap when they get up to urinate due to a brief loss of consciousness. Most patients may experience dizziness, nausea, and panic before the onset of fainting, but some do not have any uncomfortable aura before fainting.
This type of syncope usually occurs at the end of urination, but it can also occur before urination. The duration of the syncope can last as little as a few seconds or as much as half an hour. Although the disease has a tendency to recur, the frequency varies from patient to patient, with some having several episodes in a month and others having only one or two episodes in a year. It has been clinically observed that the triggering factors of the disease are mainly alcohol consumption, lack of sleep, excessive fatigue, reduced diet and change of body position.
Pathological description
There is no unified conclusion as to how urinary syncope is caused. However, the majority of experts believe that the disease is mainly caused by hypotension due to vasodilatation and contraction disorders, plant nerve dysfunction, cardiac arrhythmias, fluctuations in blood pressure, and an increase in pressure in the chest cavity due to excessive breath-holding during urination, which causes a momentary lack of blood supply to the brain. It is these factors that affect the patient’s cardiac blood output, causing syncope to occur due to cerebral ischemia. The patient can wake up on his own about two minutes after the onset of syncope and no sequelae are left.
Preventive treatment
Although the prognosis for voiding syncope is good, and most patients stop having it on their own as they get older. However, because the patient will suddenly faint at the onset of the disease, it is easy to cause trauma and can be life-threatening in serious cases, so it is very important for the patient to prevent the occurrence of syncope. Clinical practice proves that the effective measures to prevent and control this disease are mainly as follows.
①Patients should take a sitting position when getting up to urinate, and then stand up slowly. Do deep breathing action when urinating (to prevent excessive breath holding).
② Do not hold urine, and urinate as soon as you have the urge to do so. Men who have frequent syncope episodes can take squatting or sitting urination.
③To actively treat various chronic diseases such as neurasthenia, tuberculosis, and gastroduodenal ulcer.
④To participate in more physical activities to enhance physical fitness.
⑤ Avoid alcohol abuse and overexertion.
⑥Patients can take oral atropine or 654-2 during frequent attacks of this disease.
⑦After a patient has syncope, he or she should be laid flat immediately, and then finger pressure should be applied to the patient’s acupuncture points such as Renzhong, Neiguan, and Feosanli in order to wake him or her up as soon as possible. It should be noted that if the patient is suspected of having cranial trauma or cerebral hemorrhage, he should be quickly sent to the hospital for consultation and treatment to prevent accidents.