Stranguria is the condition in which pain is felt in the act of urinating (urination) or in which the emission of urine is slow and intermittent, to the point of assuming the rhythm of one drop at a time. This is the definition commonly used to describe the symptom symptom.
Furthermore, bladder tenesmus is associated with this disorder, a painful contraction of the detrusor muscle of the bladder which occurs at the end of urination and which generates the urgent sensation of having to urinate again.
To the symptoms described, typical of stranguria, then, depending on the triggering pathology, other manifestations such as fever, chills, burning, pollakiuria (feeling of having to urinate frequently without an increase in urine produced over the course of 24 hours) and nocturia (condition in which there is a production of nocturnal urine greater than usual).
In most cases, stranguria is a consequence of easily resolved inflammatory or infectious phenomena that leave no outcome to any consequence. However, in some cases it can be the telltale symptom of a more serious pathological picture.
Therefore, when symptoms described as typical of stranguria (pain, slow urination, bladder tenesmus) the invitation is to contact your general practitioner and be directed to appropriate analyzes useful for understanding the triggering cause .
At this point, provided the information useful to understand the nature of the disorder, let’s move on to illustrate what the pathologies triggering stranguria are and how they are divided .

What are the causes of stranguria Stranguria
can be caused by the onset of multiple clinical conditions. In most cases, these are easily resolved disorders, resulting from inflammation or infection; in other cases, however, stranguriaand the symptom of a disease of greater medical interest and which requires targeted and specific interventions in order not to degenerate.
Let’s see an overview of the main causes of stranguria. We have decided to divide them according to the anatomical site concerned for a simpler consultation.
Let’s start with the causes involving the lower urinary tract.

Cystitis and urethritis
In both cases, these are infections that affect the genitourinary system but do not manifest fever. Cystitis is caused by the proliferation of bacteria in the bladder that can come from the rectum or vagina, as a consequence of the alteration of the natural vaginal bacterial flora, or from the urethra following frequent sexual intercourse.
Cystitis typically affects the female sex, this in relation to the anatomical characteristics of the female body; while in the male this pathology is never a true cystitis, but involves the prostate involvement and we are therefore talking about prostatitis which we will deepen later.
What are the symptoms of cystitis?
In addition to the urge to urinate, the patient typically experiences an unpleasant burning sensation and persistent pain that increases upon urination. The disorder can manifest itself as a single episode, but it is not uncommon to occur with recurrence or to take on a cyclical and chronic character. Urethritis
_instead it involves both the female and male population and is a sexually transmitted infection (STD) in which the most involved pathogens are Neisseria (responsible for gonorrhea ), and Chlamydia . How urethritis
manifests itself
Similarly to what happens in cystitis, people affected by urethritis experience a strong and unpleasant sensation of burning and painaccompanying the act of urination. The burning sensation mainly involves the male population, this is due to the anatomical structures for which in humans the reproductive and urinary systems share their last tract in the urethra. In Neisseria bacterium urethritis, the pathogen responsible for gonorrhea, there is also the presence of pus secretions that come out of the urethra.
Infections involving the lower urinary tract have the ability to rise from the bladder through the ureters (long ducts that join the bladder to the kidney) to target the kidneys and result in pathologies affecting these organs. In the male they can also give rise to prostatitis and epididymitis.

The phenomenon that for the female gender takes the name of cystitis, in the male it takes the name of prostatitis . This is because the bladder and the prostate are two intimately connected organs and the involvement of the bladder in a pathological picture easily determines repercussions on the prostate (chestnut-shaped gland lying inferior to the bladder). Two forms are identified, one bacterial and one chronic.
Prostatitis of bacterial origin is a very frequent and easy to recognize condition because in addition to the characteristic signs of pollakiuria (urgency in urination), burning that increases at the moment of urination and a sensation of pressure or pelvic weight, the presence of fever is added. , chills and body aches.
There are also chronic prostatitis that evolve from acute bacterial prostatitis if not adequately treated. In this second case the symptoms are persistent and prolonged, but the patient feels the disturbance in a more nuanced and localized way.

This is an infectious process that affects the kidney and renal pelvis, but which can also affect the lower urinary tract, therefore the bladder and urethra. It is not infrequent that symptoms such as cystitis, disturbances during urination, burning and pain also arise from this infection . Pyelonephritis
_it is a disorder that affects women more frequently than men and is characterized by the concomitance of additional symptoms such as flank pain , fever, chills, nausea and sometimes vomiting.

Kidney stones
These are crystals that are formed in relation to several factors, such as a diet rich in proteins , poor hydration and some kidney diseases. These crystals , passing through the urinary tract towards the bladder, obstruct its caliber causing severe pain. Kidney stones
once reached the bladderthey will be expelled through the urethra during the act of urination, and as can be easily understood, the rubbing of these formations on the walls of the urethra causes pain, burning and sometimes bleeding. Furthermore, stranguria
can occur in subjects suffering from benign prostatic hypertrophy, a disease that generally affects men over 50 years of age. It is a slow-evolving neoplastic process that involves an increase in the volume of the prostate (a small chestnut-shaped gland located below the bladder).
The enlargement of the prostate gland exerts greater pressure on the bladder, generating in the subject the sensation of having to urinate frequently. A characteristic sign of prostatic hypertrophy is the moment of hesitation that is felt immediately before the act of urination, which can be accompanied by pain and burning.

How to make the diagnosis
As we have seen, the triggering causes of stranguria are various and of different severity, it is therefore necessary to undergo the analyzes useful to investigate the disorder indicated by your doctor. We also invite you not to delay waiting for the symptoms to disappear on their own, as this attitude could worsen your condition, making it necessarymore invasive and prolonged treatments .
During the anamnesis phase, the doctor goes to investigate the symptoms felt by the patient, therefore how long he has felt pain on urination, when it occurs and whether other symptoms such as fever, pollakiuria , burning and nocturia are associated with the symptoms of stranguria . This phase is followed by the physical examination, at which time the doctor can palpate the patient’s abdomen and pelvis looking for any masses, swellings or skin manifestations.
Based on the diagnostic suspicions, the doctor can guide the diagnosis by subjecting the subject to more specific analyzes, such as a simple blood or urine sample., useful to identify the presence of an infection or an ultrasound, instrumental diagnostic examination that allows to evaluate the presence of stones or masses.

What are the treatments we have available
The treatments to relieve the symptoms of stranguria act in a targeted manner on the actual root cause of the disorder, therefore, they must only be prescribed by a doctor after having read all the tests and after have come to a specific diagnosis.
In case of infections, very commonly they are administered to antibiotic drugs, to which anti-inflammatory drugs can be added to attenuate the inflammation processes.
In the case of kidney stones, painkillers and anti-inflammatory drugs are generally administered, but sometimes surgery is necessary, especially when the size of the crystal is considerable.
If the patient has been diagnosed with cancer , or prostatic hypertrophy, therapy must take into account many factors such as the patient’s age, general health conditions, the concomitance of other pathologies and the intake of drugs. All conditions that must be carefully referred to a specialist doctor.
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