Episode Transcript
Announcer: Is it bad enough to go to the emergency room? Or isn't it? You're listening to "ER or Not" on The Scope.
Interviewer: You're having a hard time peeing. Is that a reason to go to the ER or not? Dr. 特洛伊·马德森（Troy Madsen）是犹他大学医疗保健中心的急诊室医生. 当然“急诊室与否”是一个大发娱乐决定是否值得去急诊室的游戏, so having a hard time urinating. 就像，我的意思是很难让溪流流动起来. ER or not?
Dr. Madsen: 所以这是一个真正取决于上下文的问题. 如果你是一个65岁的男性，你很难让水流下去，你觉得你的膀胱要爆炸了, 那么你绝对需要去急诊室这是大发娱乐在急诊室看到的一种常见的情况老年男性会得到前列腺肿大，然后他们就不能小便了. Nothing will come out, 然后你推他们的肚子，感觉他们肚子里有个篮球. 只是他们的膀胱太满了，底线是, these people need to have a catheter placed. 上面有东西让尿液通过阻塞, past the prostate, get the urine flowing, 所以这绝对是去急诊室的一个理由.
Interviewer: 好吧，如果是你爷爷或者你老爸? Yes. Not the case for women?
Dr. Madsen: Often not, 通常在其他人身上，他们描述的是一种感觉，他们想小便，但他们就是不能去, 但是对于这些人来说，这通常是因为他们经常去因为他们有尿路感染这就产生了一种大发娱乐所说的感觉 . . . the medical term is urgency. It's exactly that. 这是一种迫切的感觉，你需要一次又一次地小便，但里面什么都没有, 这在尿路感染中很常见. That's something you can go to an urgent care, they can just do a quick urine test on you, say, "Yeah, you've got a urinary infection. Here you go. Here are some antibiotics. This will clear up in two or three days."
Interviewer: 但是膀胱完全充满的感觉是不存在的. 事实就是，你想走，却什么也走不出来. People start to assume, "I must be blocked."
Dr. Madsen: Right. Exactly.
Interviewer: But it's just empty. It's just nothing there.
Dr. Madsen: It's empty.
Interviewer: Yeah.
Dr. Madsen: They just have this feeling like, "I need to go. I need to go,“然后他们就一直在尝试，尝试，再尝试, 但这不像那些进来的人你推他们的肚子，然后, for a 65-year-old man, it feels like he's pregnant. He's got like this mass in his belly. 大发娱乐会在其中一些病人身上插一根导管然后抽出一升血. Just a huge volume of urine. 它就在那里堆积起来，造成很多疼痛和不适，什么也出不来.
Interviewer: Other . . . 所以尿路感染，也会影响男性? 所以像我这个年龄的人，40多岁的人，日子过得很艰难?
Dr. Madsen: It can. It's less common in men, 通常当男性得了尿路感染, we think, “会不会有别的原因导致了这种情况？?“在女性中，这要常见得多，原因很简单. The urethra is longer in men than in women. 对于女性来说，细菌更容易进入膀胱, so that's why it's more common. So yeah it does happen, but often in men, especially older men, I start to think, "Could there be something else going on? Maybe an infection in the prostate.开始考虑得更广泛一些，而不是仅仅说，“这是一些抗生素。. This should talk care of itself."
Interviewer: 其他障碍物呢，比如石头之类的东西?
Dr. Madsen: So kidney stones, the interesting thing with kidney stones, 它们从肾脏开始，当它们沿着输尿管——从肾脏到膀胱的管道——向下移动时，它们会引起疼痛，但一旦它们到达膀胱, the urethra, 所以从膀胱引出的管子比输尿管大, 所以一旦它们到达那里，它们就会卡在尿道里，导致你不能小便，这真的有点奇怪和不寻常.
Interviewer: Got you.
Dr. Madsen: 所以大多数人会在其中一条输尿管. You've still got the other side working. You've still got that kidney producing urine. The urine's still going to the bladder. 所以我并不经常看到肾结石患者说，“我就是尿不出来." I mean, 通常他们只是痛苦地扭动，因为那里疼痛得很厉害, 但他们仍然有规律地排尿，我不能说我曾经见过结石如此之大以至于它一直在膀胱里，然后卡在尿道里，所以他们不能把任何东西取出来.
Interviewer: All right, so just to be sure here, if somebody's having a difficult time peeing, 如果是老年人，可能是前列腺肥大, definitely go to the ER. 对其他人来说，这可能不是阻塞. It's probably a urinary tract infection. Go to an urgent care.
Dr. Madsen: Probably.
Interviewer: And we've covered everything?
Dr. Madsen: 没错，你必须，再一次，把整个事情放在上下文中. 如果你说的是一个有很多健康问题的人你认为他们不能尿尿是因为 . . . 他们只是因为肾衰竭而不小便，那就完全是另一回事了. 对于这些人来说，他们并不是觉得“我要尿尿”." It's more just like, "Hey, I'm not peeing."
Interviewer: Oh okay.
Dr. Madsen: 这只是因为他们的肾脏停止工作，身体不再分泌尿液.
Announcer: Have a question about a medical procedure? Want to learn more about a health condition? With over 2,与大发娱乐的医生和专家进行了000次访谈, 你很有可能会找到你想知道的. Check it out at thescoperadio.com.
updated: September 21, 2018
originally published: November 7, 2016