A 23 year old patient came with history of syncope while passsing urine three times in a period of 2 months.The first episode happened when he got up during the sleep.
The other two episodes happened without any provokative factors.
His routine biochemical and hematological tests were normal.ECG and ECHO tests were too normal.His VMA levels in urine were normal.
His USG KUB and uroflowometry were within the normal limits.
Finally he was given reassurance and advised some life style modifying factors.
To sit while urinating
To sit on the edge of the bed for a while before getting up and going to the toilet
To avoid micturition while feeling sleepy.
Review of the literature:
Micturition syncope fainting shortly after or during urination.
The patients can have concomitant nausea; vomiting and can feel dizzy before loss of consciousness. Some people can have syncope following or during vomiting, defecation or coughing (About 61% with micturition syndrome also suffered from other kinds of syncope).
It is more common in male. It is responsible for 2.4 to 8.4 percent of all syncope. The events often occur at night or after awaking. A combination of postural hypotension and straining is always found in such cases. Defecation syncope is a relatively rare disorder that occurs typically in middle-aged or older individuals and affects women more often than men. More than one third of patients with defecation syncope die within 2 years of complications of their underlying diseases.
The mechanism of micturition syncope is still unknown but believed that it is related to vasovagal syncope.
During micturition there is increased vagal tone as a result from straining (Valsalva maneuver) which results in bradycardia leads to syncope due to decreased cerebral blood flow. As clinician we should rule out cardiac causes, anemia and while does the patient strain at urination (whether he has underlying stricture disease,
A rare tumor –pheochromocytoma of the bladder can lead to such condition. In all cases it would be safer to do imaging of the bladder, check for urine VMA as a routine.
- Diagnosis mainly relies on patient history but other investigation like ECG, echocardiogram, TMT /Holter monitoring and blood tests need to rule out other diseases.
- There is no specific treatment for micturition syncope. General advice to men who have a micturition syncope includes:
- To sit while urinating
- To sit on the edge of the bed for a while before getting up and going to the toilet
- To avoid micturition while feeling sleepy
- If it is happening again and again and interfering with the life of the patient then beta blockers can be administered.
- Some urologists prescribe SSRI /antidepressants in such conditions .it may offer some help.
- If any sinus block is present cardiology intervention in the form of pace makers may be needed in rare cases.
Thanks for sharing the information about the MICTURITION SYNCOPE.
ReplyDeleteErection Problem Treatment,Men sexual disorder treatment,Sexual Dysfunction in Male,
It was during my research on HIV/Herpes that I stumbled upon the Hiv/Herpes information; information which is quite easy to find when doing a search for STD on google. I was into conspiracy at the time thought of HIV/Herpes Cured' being a conspiracy was something Ignorance though,I found pretty interesting about herbal medicine. I asked questions about the Herbal cure's on official HIV/Herpes websites and I was banned for doing so by moderators who told me that I was parroting Hiv/Herpes propaganda. This reinforced my belief that there is a cure for Hiv/Herpes Then i found a lady from germany name Achima Abelard Dr Itua Cure her Hiv so I send him a mail about my situation then talk more about it and send me his herbal medicine I drank for two weeks.And today I'm Cured no Hiv/Herpes in my life,I searched for Hiv/Herpes groups to attempt to make contact with people in order to learn more about Hiv/Herpes Herbal Cure's I believed at this time that you with the same disease this information is helpful to you and I wanted to do the best I could to spread this information in the hopes of helping other people.That Dr Itua Herbal Medicine makes me believes there is a hope for people suffering from,Parkinson's,Alzheimer’s disease,Bechet’s disease,Crohn’s disease
ReplyDelete,Cushing’s disease,Heart failure,Multiple Sclerosis,Hypertension,Colo_Rectal Cancer,Lyme Disease,Blood Cancer,Brain Cancer,Breast Cancer,Lung Cancer,Kidney Cancer,Love Spell,psoriasis,Lottery Spell,disease,Schizophrenia,Cancer,Scoliosis,Fibromyalgia,Fluoroquinolone Toxicity Syndrome Fibrodysplasia Ossificans Progressiva.Infertility,Tach Disease ,Epilepsy ,Diabetes ,Coeliac disease,,Arthritis,Amyotrophic Lateral Sclerosis,Autism,Alzheimer's disease,Adrenocortical carcinoma.Asthma, (measles, tetanus, whooping cough, tuberculosis, polio and diphtheria)Allergic diseases.Parkinson's disease,Schizophrenia,Lung Cancer,Breast Cancer,Colo-Rectal Cancer,Blood Cancer,Prostate Cancer,siva.Fatal Familial Insomnia Factor V Leiden Mutation ,Epilepsy Dupuytren's disease,Desmoplastic small-round-cell tumor Diabetes ,Coeliac disease,Creutzfeldt–Jakob disease,Cerebral Amyloid Angiopathy, Ataxia,Arthritis,Amyotrophic Lateral Scoliosis,Fibromyalgia,Fluoroquinolone Toxicity
Syndrome Fibrodysplasia Ossificans ProgresSclerosis,Seizures,Alzheimer's disease,Adrenocortical carcinoma.Asthma,Allergic diseases.Hiv_ Aids,Herpe ,Copd,Glaucoma., Cataracts,Macular degeneration,Cardiovascular disease,Lung disease.Enlarged prostate,Osteoporosis.
Dementia.,Hiv_ Aids,Herpes,Inflammatory bowel disease ,Copd,Diabetes,Hepatitis,I read about him online how he cure Tasha and Tara,Conley,Mckinney and many more suffring from all kind of disease so i contacted him . He's a herbal doctor with a unique heart of God, Contact Emal..info@drituaherbalcenter.com / drituaherbalcenter@gmail.com Phone or whatsapp..+2348149277967.