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FREQUENCY OF URINATION

Ask the Following Questions:

  1. Is the 24-hr urine volume increased? If the 24-hr urine volume is increased, then one has identified polyuria. The differential diagnosis of this condition is found on page 372 .
  2. Is there dysuria? If there is dysuria, one should consider cystitis, urethritis, prostatitis, bladder calculi, and tuberculosis of the bladder. If there is no dysuria, then a bladder neck obstruction from conditions such as prostatic hypertrophy or urethral stricture might be considered. One should also consider a spastic neurogenic bladder.
  3. Is there fever? If there is fever along with frequency of urination, this could be due to a systemic condition, but it is more important to look for pyelonephritis.

DIAGNOSTIC WORKUP

The first thing to do is a urinalysis and examine the urinary sediment. This will help determine if there is a UTI and if there is diabetes or one of the other causes of polyuria. A sterile sample of the urine should be sent to the lab for culture regardless of whether the urinalysis is normal.

If these studies are unremarkable, a 24-hr urine volume is determined. If the urine volume is substantially increased, the workup may proceed for polyuria . If the 24-hr urine volume is normal, a pelvic and rectal examination must be done for a mass that might be pressing on the bladder. Even if the pelvic and rectal exam is negative, pelvic ultrasound may disclose a pelvic mass.

The next step would be to catheterize for residual urine. If the residual urine is large, bladder neck obstruction is probably the problem, and prostatic hypertrophy, median bar hypertrophy, and urethral stricture must be considered.

Further studies include an intravenous pyelogram, cystogram, cystoscopy, and retrograde pyelography, but these should be done in consultation with a urologist. If a spastic neurogenic bladder is suspected, order cystometric tests and a neurology consult.

 

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)
  • [ read ]
  • 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: INCONTINENCE OF URINE (Algorithmic Diagnosis of Symptoms and Signs)

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