Contenido:

URINARY, Discomfort

Micturition syndrome

These are a Group of symptoms, of infectious or other causes, involving the lower urinary tract (bladder and urethra), even though sometimes it may affect the upper tract (kidneys and ureters). It consists mainly of four syndromes.

• Pain and stinging while urinating (disuria).
• Increase in the number of micturitions per day, with reduction in the amount of urine in them; that is "pissing many times small amounts" (pollakiuria).
• Feeling like urinating just after having done it (tenesmus).
• Uncontrollable desire to urinate, without letting urine out (mictional urgency).

It may come with:

• Blood in the urine (hematuria).
• Urinating at night (nicturia).
• Final drop.
• Urethral secretion.
• Lumbar or lower abdominal (under the navel) pain, together with general symptoms: fever, nausea or vomiting…

The collected urine must be examined, noticing at times a reddish colour (blood), clots, trace, cloudiness, bad smell. Reagent sticks for urine analysis may be used (DRAWER 11, first aid kit A) (see Chapter 6.7, URINE TESTS) the presence of proteins, red blood cells, white blood cells or nitrites will be regarded as abnormal

Except in the mildest cases, the patient will keep bed rest, checking temperature, pulse and breathing and examining his urine on a daily basis. The patient must drink plenty of water (enough to urinate between 1 and 1.5 litres of urine per day), never alcohol. Hot baths and heat in the lower abdomen will alleviate bladder discomfort.

In case of severe episodes or general symptoms MEDICAL ADVICE VIA RADIO is necessary.

Kidney colic (nephritic)

This happens as a consequence of calculus formation ("stones or fine sand") in the kidney or urinary tract.

A calculus may remain in the kidney without causing any problem, even though it frequently causes a not so severe pain (visceral) in the lumbar region ("of the kidneys") occasionally accompanied by blood in the urine. The acute pain (nephritic colic) only appears when a calculus obstructs the tube (ureter), which runs from the kidney to the bladder.

Colic pain is severe and appears suddenly. It starts in the back (lumbar region), below the ribs, radiating towards the groin and testicle on the same side. Each crisis may last up to ten minutes, with an analogous interval between the crisis. Vomits and shivering are frequent; the temperature usually remains within normal limits. An attack usually lasts for several hours, often finishing suddenly when the calculus runs down to the bladder.

With this kind of episode, MEDICAL ADVICE VIA RADIO must be requested immediately. In the meantime, the measures to be taken are:

• Alleviate the pain. It is the first objective. The patient must stay in bed, even though it is probable that no comfortable position is found. An intramuscular ampoule of butyl scopolamine bromide + metamizole (DRAWER 3, first aid kits A and B). Local heat may provide relief.
• Do not drink anything at first, while there is severe pain.
• Urine may be filtered through a gauze to check if the calculus or calculi have been expelled, and they should be stored for analysis later on.

Cuando se ha expulsado el cálculo, el paciente debe beber líquidos en abundancia, debiendo seguir una dieta blanda durante uno o dos días.

Urine obstruction or retention

It is the worst complication of all of these conditions. The patient is unable to urinate even though the bladder is full. There is a lot of pain, and the bladder may be felt as a hard and sensitive balloon above the pubis.

As a first measure, the patient will have a warm bath or shower, where he or she will try to relax and urinate. Keep warm, do not give anything to drink or eat and ask for MEDICAL ADVICE VIA RADIO .