Yr 3 Surgery - Urology: Symptoms, signs and investigations

Question 1

What are the main symptoms of urological problems?

Answer 1

Pain
Haematuria (macroscopic)
Lower urinary tract symptoms (LUTS - voiding symptoms and storage symptoms)
Urinary incontinence 
Male sexual dysfunction 
Haemospermia

Question 2

Where is kidney pain typically felt?

Answer 2

The renal angle (between the lower border of the 12th rib and the spine)

Question 3

Where is ureteric pain typically felt?

Answer 3

Between the renal angle and the groin

Question 4

Where is bladder pain typically felt?

Answer 4

Suprapubic region

Question 5

Where is prostatic pain typically felt?

Answer 5

In the perineum, but may radiate along the urethra to the tip of the penis.

Question 6

What is macroscopic haematuria usually associated with?

Answer 6

Sinister symptom of malignant disease, especially of the bladder and when painless.
When associated with painful voiding, is usually due to bladder infection or stones.

Question 7

Give examples of lower urinary tract symptoms.

Answer 7

Voiding symptoms:

• poor urine flow
• hesitancy
• post-micturition dribbling

Storage symptoms:

• frequency
• nocturia
• urgency
• urge incontinence

Question 8

What is stress incontinence?

Answer 8

Urine leakage that occurs at a time of increased intravesicle pressure e.g. coughing, sneezing, lifting

Results from incontinence of the urethral sphincter and bladder neck; usually related to pregnancy and child birth

Question 9

What is urge incontinence?

Answer 9

Urine leakage that occurs in association with a strong desire to void.
Urine leaks from the bladder before the patient is able to reach a toilet.
Usually caused by overactivity of the detrusor muscle.
May be idiopathic or secondary to other bladder disease.
Stress and urge incontinence frequently co-exist.

Question 10

What is insensible urine leakage?

Answer 10

Urine leakage that occurs without any associated symptoms.
Urine leaks from the bladder continuously and the patient is sometimes unaware.
Causes: overflow incontinence from chronic retention, fistulation (commonly between bladder and vagina), gross sphincter disturbance resulting from surgery or neurological disease.

Question 11

What are the types of male sexual dysfunction?

Answer 11

Erectile dysfunction
Premature ejaculation
Loss of libido

Question 12

What is haemospermia?

Answer 12

Presence of blood in ejaculate

Rarely associated with significant pathology