Micturition Syncope - Causes, Symptoms, and Prevention

Introduction

Syncope is a medical term for fainting and is a common condition. It is caused when there is a temporary drop in the amount of blood that flows to the brain. For example, it happens when there is a sudden drop in the heart rate or blood pressure or any changes in the amount of blood in the areas of the body. There are different types of syncope, and they depend on the cause of the problem. The different types of syncope include:

• Vasovagal Syncope - Vasovagal syncope is also called cardio-neurogenic syncope. It is the commonest syncope. Vasovagal syncope is caused by a sudden drop in blood pressure that causes a decrease in the blood flow to the brain. In addition, some people with vasovagal syncope have a condition called orthostatic hypotension. Orthostatic hypotension keeps the blood vessels from getting smaller when the patient stands and causes the blood to collect in the legs, leading to a sudden drop in the blood.

• Postural Syncope - A sudden drop in the blood causes postural syncope due to a sudden change in position, such as from lying down to standing. Dehydration and certain medications are also responsible for postural syncope.

• Cardiac Syncope - Cardiac syncope is caused when a blood vessel or heart condition. The conditions include obstructed blood flow in the heart due to structural heart disease, abnormal heart rhythm, blockage in the cardiac blood vessels, blood clots, valve disease, aortic stenosis, and heart failure.

• Neurologic Syncope - Neurologic syncope is caused by neurologic conditions like stroke, ischemic attack, seizure, migraine, etc.

• Postural Orthostatic Tachycardia Syndrome - This syndrome is caused by a rapid heart rate that happens when the person stands after lying or sitting down for too long. This condition is commonly seen in women. In this condition, the heart rate speeds up to 30 beats per minute.

• Situational Syncope - It is a type of vasovagal syncope that happens only during certain situations that affect the nervous system and leads to syncope. Some situations are pain, anxiety, dehydration, hunger, fear, drug use, stress, hyperventilation, forceful coughing, urinating, etc.

What Is Micturition Syncope?

Micturition syncope is fainting while a person urinates or right after a person urinates. Some people have a bowel movement or cough, and swallowing causes them to faint. There is a loss of consciousness that does not last long. But there are chances of injuries to the person from falling during this micturition syncope which is of more significant concern. People who experience micturition syncope are more prone to fainting under these circumstances. Micturition syncope is commonly seen in men. It occurs after using the bathroom early in the morning or in the middle of the night.

What Causes Micturition Syncope?

The cause of micturition syncope is unclear, but doctors believe this condition is caused by decreased heart rate and low blood pressure. The heart rate and blood pressure are higher when the bladder is full. So while one empties the bladder during urination, the blood pressure and heart rate drop because the blood vessels dilate or widen. When the blood vessels are dilated, the blood moves more slowly, so it can pool in the legs. And this affects the brain as there is not enough blood reaching it, which causes fainting. There is a decrease in blood pressure on standing while urinating or getting up from the toilet seat.

How Is Micturition Syncope Triggered?

Identifying the triggers for micturition syndrome will help prevent fainting episodes. Some factors trigger the micturition syncope. They are:

• Hunger.

• Fatigue.

• Sleep deprivation.

• Alcohol use.

• Painful urination.

• Dehydration.

• Hot weather or environment.

• Certain medical conditions like respiratory infections.

What Medications Affect Micturition Syncope?

Certain medications affect and cause micturition syncope. The medications include:

• Beta-blockers.

• Diuretics.

• Nitrates.

• ACE (angiotensin-converting enzyme) inhibitors.

• Drugs used to treat hypertension.

• Calcium channel blockers.

• Antidepressants.

• Antipsychotics.

• Alcohol.

• Illegal drugs like narcotics or cocaine.

What Are the Symptoms of Micturition Syncope?

Micturition syncope will not always happen every time one urinates. It can be a one-time experience. However, it often occurs when one has been drinking alcohol, feeling tired, hungry, dehydrated, or waking up from sleep. The symptoms of micturition syncope include:

• Sweating.

• Sickly pallor.

• Weakness.

• Dimmed vision.

• Nausea.

• Dizziness.

• Light-headedness.

Whenever a person feels dizzy, make them lie down or sit with the head between the knees. When a person is unconscious, make them lie down on their back and elevate their legs above the heart level (about 12 inches). Loosen the tight clothing or belts, if any.

One should seek medical help immediately if they have:

• A severe headache.

• Pain in the chest or lower back.

• Difficulty in breathing.

• Double vision.

• Difficulty with speech.

• Irregular heartbeat.

• Unconsciousness for a long time.

How to Prevent Micturition Syncope?

Micturition syncope is not very common. The prevention of micturition depends on recognizing the triggering factors contributing to this condition and avoiding them. Some methods can help in preventing micturition syncope.

• Make sure to sit while urinating.

• Avoid excessive alcohol intake.

• Do not get out of bed all of a sudden.

• Review the medications with the doctor.

• Make sure the floor from the bed to the bathroom is padded or carpeted.

• Urinate before going to bed.

• Avoid urinating while sleepy.

Conclusion

Micturition syncope or post-micturition syncope is fainting shortly after urinating or during urinating. A person with micturition syncope feels light-headed and dizzy. Managing micturition syncope involves identifying the triggering factors and taking the appropriate measures to prevent them.