{"id":12728,"date":"2025-07-21T08:09:42","date_gmt":"2025-07-21T12:09:42","guid":{"rendered":"https:\/\/www.rigicon.com\/glossary-term\/bladder-emptying\/"},"modified":"2026-10-06T12:50:55","modified_gmt":"2026-10-06T16:50:55","slug":"esvaziamento-vesical","status":"publish","type":"glossary-term","link":"https:\/\/www.rigicon.com\/pt-br\/glossary-term\/esvaziamento-vesical\/","title":{"rendered":"Esvaziamento Vesical"},"content":{"rendered":"","protected":false},"excerpt":{"rendered":"","protected":false},"featured_media":0,"template":"","glossary-category":[126],"glossary-product":[108,107],"class_list":["post-12728","glossary-term","type-glossary-term","status-publish","hentry","glossary-category-urological-conditions","glossary-product-conticlassic-aus","glossary-product-contireflex-enhanced-aus"],"acf":{"gt-definition":"<p>\n        O esvaziamento vesical \u00e9 o processo fisiol\u00f3gico pelo qual a urina \u00e9 completamente eliminada da bexiga por meio da contra\u00e7\u00e3o coordenada do m\u00fasculo detrusor e do relaxamento dos esf\u00edncteres uretrais.<sup>1<\/sup> Esse processo complexo requer integra\u00e7\u00e3o precisa entre o sistema nervoso central (c\u00e9rebro e medula espinhal) e o sistema nervoso perif\u00e9rico para alcan\u00e7ar a coordena\u00e7\u00e3o adequada.<sup>2<\/sup> O reflexo da mic\u00e7\u00e3o, que controla o esvaziamento da bexiga, envolve duas fases distintas: a fase de armazenamento, em que a bexiga relaxa e se enche de urina enquanto os esf\u00edncteres uretrais permanecem contra\u00eddos, e a fase de esvaziamento, em que o m\u00fasculo detrusor se contrai enquanto os esf\u00edncteres uretrais relaxam.<sup>3<\/sup>\n    <\/p>\n    <p>\n        O controle neural do esvaziamento vesical envolve m\u00faltiplas vias e neurotransmissores. Os nervos parassimp\u00e1ticos dos segmentos sacrais S2-S4 fornecem est\u00edmulo excitat\u00f3rio \u00e0 bexiga por meio da libera\u00e7\u00e3o de acetilcolina, que atua nos receptores muscar\u00ednicos (principalmente M3) do m\u00fasculo detrusor para desencadear a contra\u00e7\u00e3o.<sup>4<\/sup> Simultaneamente, a inibi\u00e7\u00e3o da atividade simp\u00e1tica (que normalmente mant\u00e9m o t\u00f4nus uretral) e da atividade som\u00e1tica dirigida ao esf\u00edncter uretral externo permite que a uretra relaxe, criando uma passagem para o fluxo de urina.<sup>5<\/sup> Essa coordena\u00e7\u00e3o \u00e9 orquestrada pelo centro pontino da mic\u00e7\u00e3o, no tronco encef\u00e1lico, enquanto centros corticais superiores proporcionam o controle volunt\u00e1rio do processo.<sup>6<\/sup>\n    <\/p>\n    <p>\n        Problemas no esvaziamento da bexiga podem levar \u00e0 reten\u00e7\u00e3o urin\u00e1ria, condi\u00e7\u00e3o em que a urina n\u00e3o pode ser completamente eliminada da bexiga, resultando em urina residual que aumenta o risco de infec\u00e7\u00f5es do trato urin\u00e1rio, les\u00e3o da bexiga e complica\u00e7\u00f5es renais.<sup>7<\/sup>\n    <\/p>","gt-synonyms":"Mic\u00e7\u00e3o da bexiga, mic\u00e7\u00e3o, mic\u00e7\u00e3o, fun\u00e7\u00e3o miccional, contra\u00e7\u00e3o do detrusor e relaxamento uretral, elimina\u00e7\u00e3o urin\u00e1ria","gt-citation":"[1] Fowler CJ, Griffiths D, de Groat WC. The neural control of micturition. Nat Rev Neurosci. 2008 Jun;9(6):453-466. DOI: 10.1038\/nrn2401\n\n[2] Yoshimura N, Chancellor MB. Neurophysiology of Lower Urinary Tract Function and Dysfunction. Rev Urol. 2003;5(Suppl 8):S3-S10. PMID: 16985987\n\n[3] Andersson KE, Arner A. Urinary bladder contraction and relaxation: physiology and pathophysiology. Physiol Rev. 2004 Jul;84(3):935-86. DOI: 10.1152\/physrev.00038.2003\n\n[4] de Groat WC, Yoshimura N. Anatomy and physiology of the lower urinary tract. Handb Clin Neurol. 2015;130:61-108. DOI: 10.1016\/B978-0-444-63247-0.00005-5\n\n[5] Birder L, Andersson KE. Urothelial signaling. Physiol Rev. 2013 Apr;93(2):653-80. DOI: 10.1152\/physrev.00030.2012\n\n[6] Griffiths D. Neural control of micturition in humans: a working model. Nat Rev Urol. 2015 Dec;12(12):695-705. DOI: 10.1038\/nrurol.2015.266\n\n[7] Sexton CC, Coyne KS, Kopp ZS, et al. The overlap of storage, voiding and postmicturition symptoms and implications for treatment seeking in the USA, UK and Sweden: EpiLUTS. BJU Int. 2009 Apr;103 Suppl 3:12-23. DOI: 10.1111\/j.1464-410X.2009.08369.x","gt-clinical-context":"<p>\n        A disfun\u00e7\u00e3o do esvaziamento vesical \u00e9 uma preocupa\u00e7\u00e3o cl\u00ednica importante: homens na faixa dos 70 anos t\u00eam um risco de aproximadamente 10%, e homens na faixa dos 80 anos um risco de aproximadamente 30%, de apresentar um epis\u00f3dio de reten\u00e7\u00e3o urin\u00e1ria aguda em 5 anos, com taxas menores nas mulheres.<sup>1<\/sup> Os problemas de esvaziamento da bexiga podem se manifestar como reten\u00e7\u00e3o urin\u00e1ria aguda (s\u00fabita) ou cr\u00f4nica (gradual), que \u00e9 a incapacidade de eliminar completamente a urina da bexiga.<sup>2<\/sup>\n    <\/p>\n    <p>\n        As causas dos problemas de esvaziamento da bexiga podem ser divididas em v\u00e1rios grupos:\n    <\/p>\n    <p>\n        <strong>Causas obstrutivas<\/strong> incluem a hiperplasia prost\u00e1tica benigna (HPB), que \u00e9 a causa mais comum em homens mais velhos, estenoses uretrais, c\u00e1lculos vesicais, tumores e, nas mulheres, cistocele ou retocele.<sup>3<\/sup> Essas obstru\u00e7\u00f5es f\u00edsicas impedem o fluxo normal de urina pela uretra, apesar de a bexiga se contrair adequadamente.\n    <\/p>\n    <p>\n        <strong>Causas neurog\u00eanicas<\/strong> envolvem a interrup\u00e7\u00e3o das vias neurais que controlam a mic\u00e7\u00e3o e incluem condi\u00e7\u00f5es como acidente vascular cerebral, esclerose m\u00faltipla, doen\u00e7a de Parkinson, neuropatia diab\u00e9tica e les\u00f5es da medula espinhal.<sup>4<\/sup> Essas condi\u00e7\u00f5es podem afetar tanto as vias aferentes (sensitivas), que detectam o enchimento da bexiga, quanto as vias eferentes (motoras), que controlam a contra\u00e7\u00e3o e o relaxamento muscular.\n    <\/p>\n    <p>\n        <strong>Causas relacionadas a medicamentos<\/strong> s\u00e3o comuns e incluem anticolin\u00e9rgicos, antidepressivos (particularmente os tric\u00edclicos), anti-histam\u00ednicos, opioides e relaxantes musculares.<sup>5<\/sup> Esses medicamentos podem interferir no controle neural normal da fun\u00e7\u00e3o vesical, frequentemente bloqueando a a\u00e7\u00e3o da acetilcolina sobre os receptores muscar\u00ednicos do m\u00fasculo detrusor.\n    <\/p>\n    <p>\n        <strong>Outros fatores<\/strong> incluem efeitos p\u00f3s-cir\u00fargicos (particularmente ap\u00f3s cirurgia p\u00e9lvica ou da coluna), infec\u00e7\u00f5es ou inflama\u00e7\u00e3o do trato urin\u00e1rio e enfraquecimento dos m\u00fasculos da bexiga devido ao envelhecimento ou \u00e0 hiperdistens\u00e3o cr\u00f4nica.<sup>6<\/sup>\n    <\/p>\n    <p>\n        O diagn\u00f3stico dos problemas de esvaziamento da bexiga normalmente envolve a medida do volume de urina residual p\u00f3s-miccional, testes urodin\u00e2micos para avaliar a fun\u00e7\u00e3o vesical e uretral, cistoscopia para visualizar a bexiga e a uretra e exames de imagem.<sup>7<\/sup> As abordagens de tratamento dependem da causa subjacente e podem incluir cateterismo (intermitente ou de demora), medicamentos (como alfabloqueadores para a HPB), cirurgia para aliviar a obstru\u00e7\u00e3o, neuromodula\u00e7\u00e3o para causas neurog\u00eanicas e t\u00e9cnicas comportamentais.<sup>8<\/sup>\n    <\/p>\n    <p>\n        As complica\u00e7\u00f5es dos problemas de esvaziamento da bexiga n\u00e3o tratados incluem infec\u00e7\u00f5es do trato urin\u00e1rio recorrentes, les\u00e3o da bexiga por hiperdistens\u00e3o cr\u00f4nica, les\u00e3o renal por refluxo de urina, incontin\u00eancia por transbordamento e c\u00e1lculos vesicais.<sup>9<\/sup> O diagn\u00f3stico precoce e o manejo adequado s\u00e3o essenciais para prevenir essas complica\u00e7\u00f5es e melhorar a qualidade de vida.\n    <\/p>","gt-related-evidence":null,"gt-featured":true,"gt-ai-referenced":false,"gt-view-count":202},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.7 (Yoast SEO v28.7) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Esvaziamento Vesical: M\u00e9todos e Avalia\u00e7\u00e3o | Rigicon<\/title>\n<meta name=\"description\" content=\"Saiba sobre esvaziamento vesical: mecanismos normais, disfun\u00e7\u00f5es e m\u00e9todos de manejo incluindo cateterismo intermitente. 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