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Symptoms » Urinary symptoms » Book Sections
 

DIFFICULTY URINATING

Ask the following questions:

  1. Is there pain on urination? The presence of pain on urination should suggest cystitis, urethritis, urethral caruncle, vesicular calculus, urethral stricture, and acute prostatitis.
  2. Are there focal neurologic signs? The presence of focal neurologic signs should suggest multiple sclerosis, poliomyelitis, cauda equina tumor, acute spinal cord injury, tabes dorsalis, and diabetic neuropathy.
  3. Is the prostate enlarged? The presence of an enlarged prostate would suggest benign prostatic hypertrophy or an advanced malignancy. A small nodular prostate may suggest an early carcinoma of the prostate. Chronic prostatitis would present with a normal-sized or small prostate that is firm.

DIAGNOSTIC WORKUP

Routine laboratory tests include a CBC, sedimentation rate, urinalysis, VDRL test, urine culture, colony count, and sensitivity. If there is a urethral discharge, a Gram stain and culture for gonococcus should be done. If this is negative, a culture for chlamydia should be done. The patient should be catheterized for residual urine. Alternatively, ultrasonography may be done to demonstrate residual urine. If there is a significant amount of residual urine, referral to a urologist for cystoscopy and cystometric testing is done.

If there are focal neurologic signs, a neurologist is consulted. An enlarged prostate or a prostate that is nodular should be an indication for a consultation with a urologist and ordering a PSA titer.

 

Book Source Details

  • Book Title: Algorithmic Diagnosis of Symptoms and Signs
  • Author(s): R. Douglas Collins
  • Year of Publication: 2003
  • Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.

Other Book Chapters Related to Urinary symptoms

Read excerpts from these other book chapters related to Urinary symptoms:

Medical Books Excerpts
  • DYSURIA
  • "Algorithmic Diagnosis of Symptoms and Signs" (2003)
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  • ENURESIS
  • "Algorithmic Diagnosis of Symptoms and Signs" (2003)
  • [ read ]
  • NOCTURIA
  • "Algorithmic Diagnosis of Symptoms and Signs" (2003)
  • [ read ]
  • POLYURIA
  • "Algorithmic Diagnosis of Symptoms and Signs" (2003)
  • [ read ]
  • PROTEINURIA
  • "Algorithmic Diagnosis of Symptoms and Signs" (2003)
  • [ read ]
  • PYURIA
  • "Algorithmic Diagnosis of Symptoms and Signs" (2003)
  • [ read ]
  • Dysuria
  • "In a Page: Signs and Symptoms" (2004)
  • [ read ]
  • Dysuria
  • "In A Page: Pediatric Signs and Symptoms" (2007)
  • [ read ]
  • Enuresis
  • "In A Page: Pediatric Signs and Symptoms" (2007)
  • [ read ]
  • Pyuria
  • "In A Page: Pediatric Signs and Symptoms" (2007)
  • [ read ]
  • DYSURIA
  • "Differential Diagnosis in Primary Care" (2007)
  • [ read ]
  • NOCTURIA
  • "Differential Diagnosis in Primary Care" (2007)
  • [ read ]
  • POLYURIA
  • "Differential Diagnosis in Primary Care" (2007)
  • [ read ]
  • PYURIA
  • "Differential Diagnosis in Primary Care" (2007)
  • [ read ]
  • Enuresis
  • "Handbook of Signs & Symptoms (Third Edition)" (2006)
  • [ read ]
  • Nocturia
  • "Handbook of Signs & Symptoms (Third Edition)" (2006)
  • [ read ]
  • Oliguria
  • "Handbook of Signs & Symptoms (Third Edition)" (2006)
  • [ read ]
  • Polyuria
  • "Handbook of Signs & Symptoms (Third Edition)" (2006)
  • [ read ]
  • Polyuria
  • "A Pocket Manual of Differential Diagnosis" (1999)
  • [ read ]
  • Dysuria
  • "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
  • [ read ]
  • Enuresis
  • "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
  • [ read ]
  • Nocturia
  • "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
  • [ read ]
  • Oliguria
  • "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
  • [ read ]
  • Polyuria
  • "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
  • [ read ]
  • Dysuria
  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
  • [ read ]
  • Nocturia
  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
  • [ read ]
  • Proteinuria
  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
  • [ read ]
  • Urinary Incontinence
  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
  • [ read ]
  • Oliguria and Anuria
  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
  • [ read ]
  • Dysuria
  • "Field Guide to Bedside Diagnosis" (2007)
  • [ read ]
  • Polyuria
  • "Field Guide to Bedside Diagnosis" (2007)
  • [ read ]
  • Bladder distention
  • "Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series" (2007)
  • [ read ]
  • Dysuria
  • "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
  • [ read ]
  • Nocturia
  • "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
  • [ read ]
  • Oliguria
  • "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
  • [ read ]
  • Polyuria
  • "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
  • [ read ]
  • Dysuria
  • "The Diagnostic Approach to Symptoms and Signs in Pediatrics" (2006)
  • [ read ]
  • Proteinuria
  • "The Diagnostic Approach to Symptoms and Signs in Pediatrics" (2006)
  • [ read ]
  • Dysuria
  • "Nursing: Interpreting Signs and Symptoms" (2007)
  • [ read ]
  • Enuresis
  • "Nursing: Interpreting Signs and Symptoms" (2007)
  • [ read ]
  • Nocturia
  • "Nursing: Interpreting Signs and Symptoms" (2007)
  • [ read ]
  • Oliguria
  • "Nursing: Interpreting Signs and Symptoms" (2007)
  • [ read ]
  • Polyuria
  • "Nursing: Interpreting Signs and Symptoms" (2007)
  • [ read ]
  • DYSURIA
  • "Differential Diagnosis in Primary Care" (2007)
  • [ read ]
  • NOCTURIA
  • "Differential Diagnosis in Primary Care" (2007)
  • [ read ]
  • POLYURIA
  • "Differential Diagnosis in Primary Care" (2007)
  • [ read ]
  • PYURIA
  • "Differential Diagnosis in Primary Care" (2007)
  • [ read ]
 

Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2008 Williams & Wilkins.

More About Causes of Urinary symptoms



More About This Book:
Title: Algorithmic Diagnosis of Symptoms and Signs
Authors: R. Douglas Collins
Publisher: Lippincott Williams & Wilkins
Copyright: 2003
ISBN: 0-7817-3805-9

 » Next page: FREQUENCY OF URINATION (Algorithmic Diagnosis of Symptoms and Signs)

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