Beruflich Dokumente
Kultur Dokumente
DR LARS All right. Welcome back to the first session here in the LUTS section of this course. LUTS is
HENNINGSOHN: lower urinary tract symptoms, and these are symptoms during the micturition cycle. The
The first phase is the storage phase. And during storage, the bladder and the lower urinary
tract can produce a couple of symptoms. The first symptom is usually urgency. Urgency is the
If you do that, it adds up to frequency, which is another symptom from the lower urinary tract
during the storage phase or filling phase of the bladder, when the bladder fills up. Frequency
during nighttime is also a symptom, and that is called nocturia. Usually at nighttime, everyone
should sleep. But having symptoms and going to the toilet adds up to nocturia.
Another symptom during the storage phase of the bladder, when the bladder should store the
urine, is leakage of urine. That is called incontinence. So we have four symptoms during the
storage phase, urgency, frequency, nocturia, and incontinence.
The other phase of micturition is emptying of the bladder or voiding. So during the emptying,
when the bladder goes from full bladder to press out the urine, we can have some symptoms
here also. The first symptom is starting problems or hesitancy. It could be problematic to start
up micturition. So hesitancy is the first symptom.
When a patient or a person has problems with starting up their micturition, they will probably
try to help the bladder a little bit, and that means usually that the patient strains and
compresses the abdominal muscles to increase the pressure over the bladder to empty. That
It's impossible to keep the pressure from the abdomen on the lower urinary tract for a long
time. So the patient has to breathe a little bit. When the patient then starts to breathe, the
weak stream, which is also a symptom, goes down again. So we can have a variable stream
or even miction in portions. That is called intermittency. Miction in portions means that one
portion comes first, and then another portion after a second, or up to a couple of minutes.
Urination during a long time is also a symptom from the lower urinary tract during the emptying
phase. And then exactly at the end of micturition, we have two symptoms that can appear. And
the first one is dribbling. Dribbling means that the patient loses a few drops or up to a couple
of milliliters when the actual micturition should have stopped already. That could be really
disturbing for the patient. It's kind of an incontinence, but it comes immediately after the
The other symptom that also is a post-micturition symptom is the feeling of residual. That
means the feeling that there's something still in the bladder that hasn't come out. That is also
not natural to feel. The bladder should be able to empty fully in a fully normal patient.
Adding to this, we have another symptom during micturition, which is called dysuria. And that
is a little different symptom. This is the pain during micturition. Pain during micturition is not
normal. These are the symptoms from the lower urinary tract, the LUTS symptoms, the
symptoms during the storage phase and the filling phase of the bladder and the symptoms of
the emptying of the bladder, the emptying symptoms.