Micturition syncope

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Micturition syncope is described as fainting attack during mostly immediately after urination due to reduction of cerebral blood flow.

Epidemiology


More common in male but female also suffer from this condition .furthermore about 61% with micturition syndrome also suffered from other kinds of syncope.

Pathophysiolgy


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. However the trigger of the vasovagal response is unclear but though to be that the bladder becomes hyper-reflexic.

Symptoms


1. Dizziness
2. lightheaded or short lived loss of consciousness when passing urine
3. Pale appearance to your skin
4. Nausea

Triggers for micturition syncope


1. Standing long periods of time
2. Heat exposure
3. Having blood drawn
4. Fear of bodily injury

Diagnosis
Diagnosis mainly relies on patient history but other investigation like ECG, echocardiogram, exercise stress test and blood tests need to rule out other diseases.

Management


Usually no treatment is required. If it enough to interfere the quality of life treatment is required like.
1. Life style changes: If felling of faint, lie down and lift the legs, this allows gravity to keep blood flowing to brain.
2. Medical treatment:

  • Beta blocker, it is not only used in hypertensive patient but it also used to prevent vasovagal syncope.
  • Antidepressants: selective serotonin reuptake inhibitor like paroxetine ,fluoxetine and sertraline is used to prevent micturition syncope.

3. Surgery: Insertion of pacemaker may help in some patient.

References:
1. www.medterms.com
2. www.mayoclinic.com
3. www.patient.co.uk
4. cat.inist.fr
5. en.wikipedia.org

2 Responses to “Micturition syncope”

  1. Drcook says:

    This is a neurological defect, but after studying I cant get the real cause of neurological problem in it… but what every you have said is really good…

  2. admin says:

    Micturition syncope, occurs after stimulation of vagus nerve (but mechanism still unknown) which leads to bradycardia and vasodilation result in syncope due to decreased cerebral blood flow ..

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