The amounts of fluid that we drink daily must be excreted through the urinary tract. The discharge from the body takes place via the bladder emptying - the micturition.

What is the micturition?

The term micturition stands in the medical jargon for the emptying of the bladder.

The term micturition stands in the medical jargon for the emptying of the bladder. The control of emptying the bladder is a complex interaction. In the urinary bladder, receptors in the bladder wall react to the degree of filling of the bladder. As the pressure increases, they urge to urinate and we feel like we need to go to the bathroom.

Older children and adults can usually control this process deliberately, delaying the passage to the toilet or giving in to urine and emptying the bladder. From a certain point of the bladder filling, however, urinating can no longer be controlled and works reflexively. How intensively the bladder pressure is experienced is individual.

Through a targeted bladder training, the bladder emptying can be trained. This training is used for therapy in case of incontinence problems, but can also be used when a person has the feeling that they have to go to the bathroom very often without having much to drink. In most cases, this feeling comes from the habit of visiting a toilet very often. Conscious prolonged patience can now delay the bubble urge.

Function & Task

The fluid that we eat every day has to be properly processed by the body and then released from the body. This happens via the urinary tract. The fluid is converted to urine in the kidneys and from there via the ureter into the bladder.

The bladder is a hollow organ and serves as a storage organ for urine. There, up to a maximum of 800 ml of urine can be collected. A urge to urinate already at about 200 to 400 ml urine. However, from about 800 ml of urine in the bladder, voluntary control is no longer possible.

From time to time, the bladder must be emptied and the urine removed from the body. During the period when the bladder is filling slowly, the bladder muscles remain idle and expand through the amount of urine so they can take in the urine. The bladder remains closed by the sphincter. If it is filled more and more, there is a urge to urinate. The emptying can be controlled by the will. When the bladder is emptied, the bladder muscles contract, causing the sphincter to become flaccid and the bladder to be deflated.

When the urination increases, people go to a toilet to empty the bladder. How often it has to be emptied varies from person to person. Depending on the amount of fluid ingested, we urinate up to 8 times a day.

Urinating takes place in 4 phases. In the beginning, the bladder muscles contract. By contracting, the inner sphincter opens in front of the urethra, then the outer sphincter. Finally, the urine flows through the urethra. This process is supported by the abdominal and pelvic muscles.

The process of micturition is controlled by the brain. The bladder musculature reacts to the filling in the bladder and reports impulses to the brain via the nerve pathways. When there is about 350 ml of urine in the bladder, the cerebrum registers urgency and controls the bladder deflation reflex when urinating through the spinal cord by sending impulses to contract the bladder muscles and relax the inner and outer sphincters.

The bladder emptying reflex can be suppressed and controlled to some degree by sending brain inhibitory impulses to the bladder muscles via the spinal cord. In some people, especially the elderly, or with incontinence problems, the voluntary control may be impaired and must be rehearsed by therapeutic measures.

Diseases & complaints

If the interaction of the bladder emptying does not work optimally, it can lead to disturbances and associated complaints. In normal urination, the bladder is emptied several times a day. In a difficult bladder emptying (dysuria) by a narrowed or blocked urethra, z. Excessive prostate, bladder stones or tumors, urination can be associated with pain.

In infections, in pregnancy, in tumors and a permanent catheter can lead to frequent bladder emptying, but in which only little urine is left (pollakisuria).

In a polyuria, an excessive amount of urine is excreted during the day. The reasons are usually diabetes mellitus or diuretic medication.

In nocturia sufferers have to empty the bladder even at night, despite the intake of normal amounts of fluid. The cause can be a heart failure or a bladder infection. Sometimes, however, it is simply a psychic assumption that suggests a high urge to urinate.

An urine (anuria) can be caused by mechanical obstacles in the urinary tract such as stones, tumors, foreign bodies or prostate enlargement, but also by emotional influences such as a blockage, in the presence of other people to water (paruresis). In urinary retention, there is a risk of residual urine formation, which can cause a bladder infection, which is usually associated with pain and burning while urinating.

An irritable bladder is a frequent urinary frequency, often associated with a fear of not being able to reach a toilet in time. The irritable bladder also reacts sensitively to cold. In case of bladder weakness (incontinence) there is an unintentional loss of urine, which is associated with shame for those affected.

There are various forms of incontinence in which the occlusion mechanism of the bladder does not function optimally or the physical interaction of the micturition is disturbed by various influences. These include stress incontinence, urge incontinence, overflow incontinence, reflex incontinence and extraurethral urinary incontinence.

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