Frequency/ Dysuria/ Nocturia Flashcards
Timeframe
Duration
Onset
Progression
Timing
Urination
Urinary volume and frequency- what’s their normal
Catheter?- ask as may not be able to see it (leg bag)
Systems review
General- FWARJCT
Urological
Storage- frequency, volume, urgency, nocturia, incontinence
Infection- dysuria, haematuria, odour, discharge
Prostatic/ voiding- hesitancy, poor flow, dribbling, feeling of incomplete voiding
Men- ask about BPH symptoms, nocturia, painful ejaculation (prostatitis)
Females- have you gone through menopause yet, pain worse during period, stop after period
Cystitis
Dysuria
Frequency and urgency
Urethritis
Dysuria
Purulent urethral discharge
Pyelonephritis
Dysuria and loin pain
Fever, chills, rigours
Vomiting
BPH
Poor flow and terminal dribbling
Hesitancy
Overflow incontinence
Elderly male
Other differentials
Detrusor instability
Prostatitis
Pregnancy
Diuretics or caffeine
Symptom analysis (esp. if dysuria)
SOCRATES
Patients perspective
Feelings and impact on life
ICE
Background
PMH- previous UTI STI renal catheters calculus trauma etc.
DH
FH
SH
Timing of pain
Pain at stat of urination- urethritis
Pain post voiding- cystitis
UTI
Cystitis- urinary frequency, urgency, dysuria
Fever and suprapubic pain
Cloudy, bloody urine with foul odour
Confusion
Pyelonephritis
Very unwell- fever rigors n and v flank pain radiating to back
Dysuria frequency urgency nocturia haematuria may be present
STI
Vaginal or urethral discharge, young sexually active patients with recent exposure, unprotected sex, new partners
Dyspareunia, painful ejaculation
Reactive arthritis- secondary to STI or gastroenteritis (conjunctivitis seen in RA, not SA)
Renal calculi
May have dysuria
Endometriosis
Chronic pelvic pain that peaks before menstruation and then dissipates
Dyspareunia, dysmenorrhea, dysuria, subfertility, lower abdominal pain
Atrophic vaginitis
Amenorrhoea, poor tissue elasticity, vaginal dryness, pain
After menopause, can cause dysuria
BPH
Get dysuria dye to uti, secondary to stasis
Investigations
Abdominal examination, urine analysis with culture microscopy and sensitivities, DRE (prostate)
Urethral and high vaginal swabs and PCR
Bloods- FBC UE CRP PSA culture
Abdominal USS and CTKUB
