Abnormalities in micturition: Difference between revisions

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__NOTOC__
__NOTOC__
{{Abnormalities in micturation}}
{{Abnormalities in micturation}}
{{CMG}} {{AE}}
{{CMG}}; {{AE}}{{ADS}}
==Overview==
==Overview==
==Classification==
[[Micturition]] is the act of passage of urine which is a normal physiological process. Any abnormality in urine can cause difficulty in passage of urine. Abnormality of [[micturition]] usually present with symptoms like [[dysuria]], [[nocturia]], increased frequency, dribbling, hesitancy and suprapubic tenderness. Various causes include [[cystitis]], [[pyelonephritis]], [[cervicitis]], [[prostatitis]], [[benign prostatic hyperplasia]]. It is important to differentiate among the different causes which can help guide the treatment.
 
==Causes==
==Causes==
* The causes of abnormalities in micturition includes causes of dysuria and incontinence:
** [[Cystitis]]
** [[Urethritis]]
** [[Pyelonephritis]]
** [[Cervicitis]]
** [[Prostatitis]]
** [[Benign prostatic hyperplasia]]
** [[Atrophic vaginitis]]
** Trauma
==Abnormalities of Micturition Differential Diagnosis==
==Abnormalities of Micturition Differential Diagnosis==


=== Differentiating the diseases that can cause abnormality in micturition: ===
=== Differentiating the diseases that can cause abnormality in micturition: ===
<span style="font-size:85%">'''Abbreviations:''' N= Normal, UTI= [[Urinary tract infection]], CBC= [[Complete blood count]], CT= [[Computed tomography]], IBS= [[Irritable bowel syndrome]], DRE= Digital rectal examination,  
<span style="font-size:85%">'''Abbreviations:''' N= Normal, UTI= [[Urinary tract infection]], CBC= [[Complete blood count]], CT= [[Computed tomography]], IBS= [[Irritable bowel syndrome]], DRE= Digital rectal examination, HSV= [[Herpes simplex virus]], RBCs= [[red blood cells]], STI= Sexually transmitted infection, PCR=[[Polymerase chain reaction]], Nl=Normal
 
</span>
{|
<small>
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
{| class="wikitable"
! colspan="3" rowspan="5" |Diseases
|-
| colspan="9" |'''Clinical manifestations'''
! colspan="3" rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
! colspan="6" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para-clinical findings
| colspan="9" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Clinical manifestations'''
! colspan="4" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para-clinical findings
| colspan="1" rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Gold standard'''
| colspan="1" rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Gold standard'''
! rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
! rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
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! colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
! colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
|-
|-
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
|-
|-
! colspan="1" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
! colspan="1" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
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! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |CBC
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |CBC
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Electrolytes
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Urinalysis
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Urinalysis
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Ultrasonography
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Ultrasonography
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |CT scan
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |CT scan
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
|-
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Dysuria
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Dysuria
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! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Nocturia
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Nocturia
|-
|-
! rowspan="9" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Inflammatory
! rowspan="10" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Inflammatory
! rowspan="2" style="background: #DCDCDC; text-align: center;" |[[Dermatological lesions|Dermatological disorders]]
! rowspan="2" style="background: #DCDCDC; text-align: center;" |[[Dermatological lesions|Dermatological disorders]]
| style="background: #DCDCDC; text-align: center;" |[[Lichen sclerosus]]<ref name="pmid26056492">{{cite journal |vauthors=Ventolini G, Patel R, Vasquez R |title=Lichen sclerosus: a potpourri of misdiagnosed cases based on atypical clinical presentations |journal=Int J Womens Health |volume=7 |issue= |pages=511–5 |date=2015 |pmid=26056492 |pmc=4431497 |doi=10.2147/IJWH.S82879 |url=}}</ref>
| style="background: #DCDCDC; text-align: center;" |'''[[Lichen sclerosus]]<ref name="pmid26056492">{{cite journal |vauthors=Ventolini G, Patel R, Vasquez R |title=Lichen sclerosus: a potpourri of misdiagnosed cases based on atypical clinical presentations |journal=Int J Womens Health |volume=7 |issue= |pages=511–5 |date=2015 |pmid=26056492 |pmc=4431497 |doi=10.2147/IJWH.S82879 |url=}}</ref>'''
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Lichenified plaques
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Lichenified plaques
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Findings of [[UTI]] in women is quite often
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |often shows UTI in women
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Biopsy]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Biopsy
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[constipation]]
* [[Constipation]]
* [[IBS]]
* [[IBS]]
|-
|-
| style="background: #DCDCDC; text-align: center;" |[[Behcet's syndrome]]<ref name="pmid10466456">{{cite journal |vauthors=Theodorou C, Floratos D, Hatzinicolaou P, Vaiopoulos G |title=Neurogenic bladder dysfunction due to Behçet's disease |journal=Int. J. Urol. |volume=6 |issue=8 |pages=423–5 |date=August 1999 |pmid=10466456 |doi= |url=}}</ref><ref name="pmid8963981">{{cite journal |vauthors=Porru D, Pau AC, Scarpa RM, Zanolla L, Cao A, Usai E |title=Behçet's disease and the neuropathic bladder: urodynamic features: case report and a literature review |journal=Spinal Cord |volume=34 |issue=5 |pages=305–7 |date=May 1996 |pmid=8963981 |doi= |url=}}</ref><ref name="pmid10037367">{{cite journal |vauthors=Cetinel B, Akpinar H, Tüfek I, Uygun N, Solok V, Yazici H |title=Bladder involvement in Behçet's syndrome |journal=J. Urol. |volume=161 |issue=1 |pages=52–6 |date=January 1999 |pmid=10037367 |doi= |url=}}</ref>
| style="background: #DCDCDC; text-align: center;" |'''[[Behcet's syndrome]]<ref name="pmid10466456">{{cite journal |vauthors=Theodorou C, Floratos D, Hatzinicolaou P, Vaiopoulos G |title=Neurogenic bladder dysfunction due to Behçet's disease |journal=Int. J. Urol. |volume=6 |issue=8 |pages=423–5 |date=August 1999 |pmid=10466456 |doi= |url=}}</ref><ref name="pmid8963981">{{cite journal |vauthors=Porru D, Pau AC, Scarpa RM, Zanolla L, Cao A, Usai E |title=Behçet's disease and the neuropathic bladder: urodynamic features: case report and a literature review |journal=Spinal Cord |volume=34 |issue=5 |pages=305–7 |date=May 1996 |pmid=8963981 |doi= |url=}}</ref><ref name="pmid10037367">{{cite journal |vauthors=Cetinel B, Akpinar H, Tüfek I, Uygun N, Solok V, Yazici H |title=Bladder involvement in Behçet's syndrome |journal=J. Urol. |volume=161 |issue=1 |pages=52–6 |date=January 1999 |pmid=10037367 |doi= |url=}}</ref>'''
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Erythema Nodosum]]
* [[Erythema nodosum]]
* [[Papules]]
* [[Papules]]
* [[Vesicles]]
* [[Vesicles]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Aphthous ulcer]] in mouth
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |None
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |None
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Neurogenic bladder]]
* [[Neurogenic bladder]]
* Genital apthous ulcers
* Genital [[Aphthous ulcer|aphthous ulcers]]
* Recurrent [[cystitis]]
* Recurrent [[cystitis]]
* [[Epididymitis]]
* [[Epididymitis]]
* [[Urethritis]]
* [[Urethritis]]
|-
|-
! rowspan="7" style="background: #DCDCDC; text-align: center;" |[[Infectious disease|Infectious diseases]]
! rowspan="8" style="background: #DCDCDC; text-align: center;" |[[Infectious disease|Infectious diseases]]
| style="background: #DCDCDC; text-align: center;" |[[Cystitis]]
| style="background: #DCDCDC; text-align: center;" |'''[[Cystitis]]<ref name="pmid21789096">{{cite journal |vauthors=Grover S, Srivastava A, Lee R, Tewari AK, Te AE |title=Role of inflammation in bladder function and interstitial cystitis |journal=Ther Adv Urol |volume=3 |issue=1 |pages=19–33 |date=February 2011 |pmid=21789096 |pmc=3126088 |doi=10.1177/1756287211398255 |url=}}</ref><ref name="pmid24282470">{{cite journal |vauthors=Eken A, Alma E |title=Emphysematous cystitis: The role of CT imaging and appropriate treatment |journal=Can Urol Assoc J |volume=7 |issue=11-12 |pages=E754–6 |date=2013 |pmid=24282470 |pmc=3840514 |doi=10.5489/cuaj.472 |url=}}</ref>'''
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Leukopenia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Leukopenia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[WBC]]
* [[Leukocyte esterase]]
* [[Leukocyte esterase]]
* [[Nitrite|Ntrite]]
* [[Nitrite|Nitrite]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* Bladder wall thickening
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* Intraluminal gas in emphysematous cystitis
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Hydronephrosis]]
* Beaded necklace like in emphysematous cystitis
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Urine culture]] and sensitivity
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
|-
|-
| style="background: #DCDCDC; text-align: center;" |[[Urethritis]]
| style="background: #DCDCDC; text-align: center;" |'''[[Urethritis]]<ref name="Glicksman1967">{{cite journal|last1=Glicksman|first1=Joseph M.|title=Gonococcal Skin Lesions|journal=Archives of Dermatology|volume=96|issue=1|year=1967|pages=74|issn=0003-987X|doi=10.1001/archderm.1967.01610010080015}}</ref><ref name="Siboulet1955">{{cite journal|last1=Siboulet|first1=A.|title=Inclusion Bodies in Non-Gonococcal Urethritis, also Skin Lesions with Inclusions|journal=Sexually Transmitted Infections|volume=31|issue=4|year=1955|pages=235–237|issn=1368-4973|doi=10.1136/sti.31.4.235}}</ref><ref name="TsaiLi2013">{{cite journal|last1=Tsai|first1=Chia-Chun|last2=Li|first2=Ching-Chia|title=Nonchlamydial nongonococcal urethritis in men|journal=Urological Science|volume=24|issue=3|year=2013|pages=73–77|issn=18795226|doi=10.1016/j.urols.2013.06.001}}</ref>'''
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |+
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Keratoderma blennorrhagica]] - in [[disseminated gonococcal infection]]
* [[Vesicles]] - [[HSV]]
* Painless [[ulcer]] - [[syphilis]]
* Warts - [[Condyloma acuminatum]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Leukocytosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Urethral swab for culture, NAAT
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
|-
|-
| style="background: #DCDCDC; text-align: center;" |[[Pyelonephritis]]
| style="background: #DCDCDC; text-align: center;" |'''[[Pyelonephritis]]<ref name="pmid21983846">{{cite journal |vauthors=Gil-Ruiz MA, Alcaraz AJ, Marañón RJ, Navarro N, Huidobro B, Luque A |title=Electrolyte disturbances in acute pyelonephritis |journal=Pediatr. Nephrol. |volume=27 |issue=3 |pages=429–33 |date=March 2012 |pmid=21983846 |doi=10.1007/s00467-011-2020-9 |url=}}</ref><ref name="pmid472247">{{cite journal |vauthors=Edell SL, Bonavita JA |title=The sonographic appearance of acute pyelonephritis |journal=Radiology |volume=132 |issue=3 |pages=683–5 |date=September 1979 |pmid=472247 |doi=10.1148/132.3.683 |url=}}</ref>'''
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |+
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Urgency
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Leukocytosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* [[WBC]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* [[Leukocyte esterase]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* [[Nitrite|Ntrite]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* Hypoechoic when there is edema (swollen [[kidney]])
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* Gas bubbles in [[emphysematous pyelonephritis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Round swollen [[Kidney|kidneys]]
* Hypodense appearance
* [[Abscess|Abscesses]] may not be present
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Urinalysis]] and [[Urine culture]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Diseases'''
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Dysuria
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Frequency
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Dribbling
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hesitancy
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Nocturia
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Suprapubic tenderness
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Skin lesions
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CBC
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Urinalysis
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Ultrasonography
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CT scan
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
|-
|-
| style="background: #DCDCDC; text-align: center;" |[[Vulvovaginitis]]
| style="background: #DCDCDC; text-align: center;" |'''[[Vulvovaginitis]]<ref name="pmid20461391">{{cite journal |vauthors=Esim Buyukbayrak E, Kars B, Karsidag AY, Karadeniz BI, Kaymaz O, Gencer S, Pirimoglu ZM, Unal O, Turan MC |title=Diagnosis of vulvovaginitis: comparison of clinical and microbiological diagnosis |journal=Arch. Gynecol. Obstet. |volume=282 |issue=5 |pages=515–9 |date=November 2010 |pmid=20461391 |doi=10.1007/s00404-010-1498-x |url=}}</ref>'''
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |+
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Excoriation|Excoriations]] in [[vulva]]
*<nowiki/><nowiki/><nowiki/>[[Genital ulcer]]<nowiki/>[[Genital ulcer|ation]]
*<nowiki/>[[Candida]] thrus<nowiki/>h
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Thick white discharge
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Microbiological diagnosis
* Wet mount
* [[PCR]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
|-
|-
| style="background: #DCDCDC; text-align: center;" |[[Cervicitis]]
| style="background: #DCDCDC; text-align: center;" |[[Cervicitis|'''Cervicitis''']]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Erythematous]]
* Friable
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Thick yellow green pus
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Leukocytosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[WBC]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl or show [[PID]] like feature
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl or show [[PID]] like feature
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Culture of vaginal discharge
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[NAAT]] for gonocooccal [[cervicitis]]
|-
|-
| style="background: #DCDCDC; text-align: center;" |[[Prostatitis]]  
| style="background: #DCDCDC; text-align: center;" |[[Prostatitis|'''Prostatitis''']]  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Tender [[prostate]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Leukocytosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[WBC]]
* [[Leukocyte esterase]]
* [[Nitrite|Nitrite]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Urine culture]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Prostate massage for [[chronic prostatitis]] leads to raised [[leukocytes]] in [[urine]]
|-
|-
| style="background: #DCDCDC; text-align: center;" |[[Epididymoorchitis]]
| style="background: #DCDCDC; text-align: center;" |'''[[Epididymoorchitis]]<ref name="pmid19378875">{{cite journal |vauthors=Trojian TH, Lishnak TS, Heiman D |title=Epididymitis and orchitis: an overview |journal=Am Fam Physician |volume=79 |issue=7 |pages=583–7 |date=April 2009 |pmid=19378875 |doi= |url=}}</ref>'''
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* [[Cremasteric reflex]]es present
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* [[Prehn's sign]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Leukocytosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[WBC]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Urine culture]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Ceftriaxone]] for STI
* [[Levofloxacin]] for coliform bacteria
|-
|-
! rowspan="11" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Non-inflammatory
! rowspan="9" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Non-inflammatory
! rowspan="2" style="background: #DCDCDC; text-align: center;" |[[Anatomic]]
! rowspan="3" style="background: #DCDCDC; text-align: center;" |[[Anatomic]]
| style="background: #DCDCDC; text-align: center;" |[[Urethral stricture]]
| style="background: #DCDCDC; text-align: center;" |[[Urethral stricture|'''Urethral stricture''']]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[RBCs]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Post void residual; volume is high
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Retrograde urethrogram+[[cystoscopy]](urodynamic studies)
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
|-
|-
| style="background: #DCDCDC; text-align: center;" |[[Benign prostatic hyperplasia|Benign prostatic hyperplasia (BPH)]]
| style="background: #DCDCDC; text-align: center;" |'''[[Benign prostatic hyperplasia|Benign prostatic hyperplasia (BPH)]]<ref name="pmid26816845">{{cite journal |vauthors=Foo KT |title=Diagnosis and treatment of benign prostate hyperplasia in Asia |journal=Transl Androl Urol |volume=4 |issue=4 |pages=478–83 |date=August 2015 |pmid=26816845 |pmc=4708589 |doi=10.3978/j.issn.2223-4683.2015.08.07 |url=}}</ref>'''
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
Line 257: Line 296:
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Enlarged and smooth prostate on DRE
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |May have [[UTI]] like picture ocassionally
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Enlarged [[prostate]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |None
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[TURP]] is gold standard treatment
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
|-
|-
! rowspan="2" style="background: #DCDCDC; text-align: center;" |[[Drug]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Diseases'''
| style="background: #DCDCDC; text-align: center;" |[[Spermicide|Spermicides]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Dysuria
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Frequency
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Dribbling
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hesitancy
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Nocturia
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Suprapubic tenderness
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Skin lesions
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CBC
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Urinalysis
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Ultrasonography
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CT scan
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
|-
|-
| style="background: #DCDCDC; text-align: center;" |[[Cyclophosphamide]]
! rowspan="2" style="background: #DCDCDC; text-align: center;" |[[Gynecological]]
| style="background: #DCDCDC; text-align: center;" |'''[[Atrophic vaginitis]]<ref name="pmid27472999">{{cite journal| author=Gandhi J, Chen A, Dagur G, Suh Y, Smith N, Cali B et al.| title=Genitourinary syndrome of menopause: an overview of clinical manifestations, pathophysiology, etiology, evaluation, and management. | journal=Am J Obstet Gynecol | year= 2016 | volume= 215 | issue= 6 | pages= 704-711 | pmid=27472999 | doi=10.1016/j.ajog.2016.07.045 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27472999  }}</ref>'''
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
|-
! rowspan="2" style="background: #DCDCDC; text-align: center;" |[[Endocrine disorders]]
| style="background: #DCDCDC; text-align: center;" |[[Atrophic vaginitis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* [[Vaginal dryness]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* Vaginal [[erythema]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* [[Excoriation]] marks
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Vaginal discharge]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Thinning of [[endometrium]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Clinical examination]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
|-
|-
| style="background: #DCDCDC; text-align: center;" |[[Endometriosis]]
| style="background: #DCDCDC; text-align: center;" |[[Endometriosis|'''Endometriosis''']]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* [[Dyspareunia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* [[Dyschezia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Cystic masses attached to [[adnexa]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Cysts]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Laparoscopy]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Dysmenorrhea]]
* [[Dysmenorrhea]]
Line 350: Line 366:
|-
|-
! rowspan="2" style="background: #DCDCDC; text-align: center;" |[[Malignancy]]
! rowspan="2" style="background: #DCDCDC; text-align: center;" |[[Malignancy]]
| style="background: #DCDCDC; text-align: center;" |[[Bladder cancer]]
| style="background: #DCDCDC; text-align: center;" |[[Bladder cancer|'''Bladder cancer''']]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Hematuria]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Anemia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Hematuria]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Nodal involvement in the [[pelvis]] or [[retroperitoneum]], [[visceral]], [[pulmonary]], or [[osseous]] [[metastasis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Cystoscopy]] and [[biopsy]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
|-
|-
| style="background: #DCDCDC; text-align: center;" |[[Vulvovaginal disorders|Vulvovaginal cancer]]
| style="background: #DCDCDC; text-align: center;" |'''[[Vulvovaginal disorders|Vulvovaginal cancer]]<ref name="KimShinagare2013">{{cite journal|last1=Kim|first1=Kyung Won|last2=Shinagare|first2=Atul B.|last3=Krajewski|first3=Katherine M.|last4=Howard|first4=Stephanie A.|last5=Jagannathan|first5=Jyothi P.|last6=Zukotynski|first6=Katherine|last7=Ramaiya|first7=Nikhil H.|title=Update on Imaging of Vulvar Squamous Cell Carcinoma|journal=American Journal of Roentgenology|volume=201|issue=1|year=2013|pages=W147–W157|issn=0361-803X|doi=10.2214/AJR.12.9594}}</ref>'''
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Edematous [[vulva]]
* Lesion on the inner edges of [[vulva]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |When infected,
* [[WBC]]
* [[Leukocyte esterase]]
* [[Nitrite|Nitrite]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Contrast enhancement (vascularity) showing the extent of the disease
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Biopsy]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
|-
|-
! rowspan="3" style="background: #DCDCDC; text-align: center;" |[[Iatrogenic]]
! rowspan="2" style="background: #DCDCDC; text-align: center;" |[[Iatrogenic]]
| style="background: #DCDCDC; text-align: center;" |[[Genitourinary system|Genitourinary instrumentation]]
| style="background: #DCDCDC; text-align: center;" |'''[[Genitourinary system|Genitourinary instrumentation]]/ pelvic irradiation'''
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Erythema]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Leukocytosis]] maybe present
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |When infected,
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* [[WBC]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* [[Leukocyte esterase]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* [[Nitrite|Nitrite]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Culture]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
|-
| style="background: #DCDCDC; text-align: center;" |[[Pelvic]] [[irradiation]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
|-
|-
| style="background: #DCDCDC; text-align: center;" |[[Trauma]]
| style="background: #DCDCDC; text-align: center;" |[[Trauma|'''Trauma''']]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Laceration]]/[[bruise]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Hematuria]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Anemia]]
* [[Leukocytosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Hematuria]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Blood in [[pelvic cavity]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Blood in [[pelvic cavity]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Laparotomy]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
|}
|}
</small>


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Latest revision as of 16:19, 7 August 2018


Micturation Abnormalities Microchapters

Overview

Causes

Differential Diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2]

Overview

Micturition is the act of passage of urine which is a normal physiological process. Any abnormality in urine can cause difficulty in passage of urine. Abnormality of micturition usually present with symptoms like dysuria, nocturia, increased frequency, dribbling, hesitancy and suprapubic tenderness. Various causes include cystitis, pyelonephritis, cervicitis, prostatitis, benign prostatic hyperplasia. It is important to differentiate among the different causes which can help guide the treatment.

Causes

Abnormalities of Micturition Differential Diagnosis

Differentiating the diseases that can cause abnormality in micturition:

Abbreviations: N= Normal, UTI= Urinary tract infection, CBC= Complete blood count, CT= Computed tomography, IBS= Irritable bowel syndrome, DRE= Digital rectal examination, HSV= Herpes simplex virus, RBCs= red blood cells, STI= Sexually transmitted infection, PCR=Polymerase chain reaction, Nl=Normal

Diseases Clinical manifestations Para-clinical findings Gold standard Additional findings
Symptoms Physical examination
Lab Findings Imaging
Fever Urinary symptoms Supra-pubic tenderness Skin lesions Other CBC Urinalysis Ultrasonography CT scan
Dysuria Frequency Dribbling Hesitancy Nocturia
Inflammatory Dermatological disorders Lichen sclerosus[1] + + Lichenified plaques Nl Findings of UTI in women is quite often Nl Nl Biopsy
Behcet's syndrome[2][3][4] + + + + Aphthous ulcer in mouth Nl Nl Nl Nl None
Infectious diseases Cystitis[5][6] + + + + + + + Nl Leukopenia
  • Bladder wall thickening
  • Intraluminal gas in emphysematous cystitis
Urine culture and sensitivity
Urethritis[7][8][9] + + + + + Leukocytosis Nl Nl Nl Urethral swab for culture, NAAT
Pyelonephritis[10][11] + + + + ± Nl Urgency Leukocytosis Urinalysis and Urine culture
Diseases Fever Dysuria Frequency Dribbling Hesitancy Nocturia Suprapubic tenderness Skin lesions Other CBC Urinalysis Ultrasonography CT scan Gold standard Additional findings
Vulvovaginitis[12] ± + + + + Thick white discharge Nl Nl Nl Nl Microbiological diagnosis
Cervicitis + ± + ± + Thick yellow green pus Leukocytosis WBC Nl or show PID like feature Nl or show PID like feature Culture of vaginal discharge NAAT for gonocooccal cervicitis
Prostatitis + + + + + + ± Tender prostate Leukocytosis Nl Nl Urine culture Prostate massage for chronic prostatitis leads to raised leukocytes in urine
Epididymoorchitis[13] ± + + + Leukocytosis WBC Nl Nl Urine culture
Non-inflammatory Anatomic Urethral stricture + ± + Nl RBCs Post void residual; volume is high Retrograde urethrogram+cystoscopy(urodynamic studies)
Benign prostatic hyperplasia (BPH)[14] + + + + + Enlarged and smooth prostate on DRE Nl May have UTI like picture ocassionally Enlarged prostate None TURP is gold standard treatment
Diseases Fever Dysuria Frequency Dribbling Hesitancy Nocturia Suprapubic tenderness Skin lesions Other CBC Urinalysis Ultrasonography CT scan Gold standard Additional findings
Gynecological Atrophic vaginitis[15] + + ± ± + Vaginal discharge Nl Nl Thinning of endometrium Nl Clinical examination
Endometriosis + Nl Nl Cystic masses attached to adnexa Cysts Laparoscopy
Malignancy Bladder cancer + + Hematuria Anemia Hematuria Nl Nodal involvement in the pelvis or retroperitoneum, visceral, pulmonary, or osseous metastasis Cystoscopy and biopsy
Vulvovaginal cancer[16] ± ± ±
  • Edematous vulva
  • Lesion on the inner edges of vulva
Nl When infected, Nl Contrast enhancement (vascularity) showing the extent of the disease Biopsy
Iatrogenic Genitourinary instrumentation/ pelvic irradiation + ± ± ± ± Erythema Leukocytosis maybe present When infected, Nl Nl Culture
Trauma ± ± ± Laceration/bruise Hematuria Hematuria Blood in pelvic cavity Blood in pelvic cavity Laparotomy

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