Abnormalities in micturition

Micturation Abnormalities Microchapters
Overview
Causes
Differential Diagnosis

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

Classification

• There is no established system for the classification of abnormalities in micturition.

Causes

• The causes of abnormalities in micturition includes causes of dysuria and incontinence:

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,

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	Electrolytes	Urinalysis	Ultrasonography	CT scan	Other
				Dysuria	Frequency	Dribbling	Hesitancy	Nocturia
Inflammatory	Dermatological disorders	Lichen sclerosus	–	+	–	–	+	–	–	Lichenified plaques	–	N	N	often shows UTI in women	N	N	N	Biopsy	Constipation IBS
		Behcet's syndrome	–	+	+	–	+	+	–	Erythema nodosum Papules Vesicles	aphthous ulcer in mouth	N	N	N	N	N	N	None	Neurogenic bladder Genital aphthous ulcers Recurrent cystitis Epididymitis Urethritis
	Infectious diseases	Cystitis	+	+	+	+	+	+	+	N	–	Leukopenia	N	WBC Leukocyte esterase Ntrite	Bladder wall thickening Intraluminal gas in emphysematous cystitis	hydronephrosis beaded necklace like in emphysematous cystitis	N	Urine culture to sensitivity	N
		Urethritis	+	+	+	–	+	–	+	Keratoderma blennorrhagica- in disseminated gonococcal infection Vesicles - HSV Painless ulcer- syphilis Warts- Condyloma acuminatum	–	Leukocytosis	N	N	N	N	N	Urethral swab for culture, NAAT	N
		Pyelonephritis	+	+	+	–	–	+	±	N	Urgency	Leukocytosis	Hyperkalemia	WBC Leukocyte esterase Ntrite	Hypoechoic when there is edema(swollen kidney) Gas buubles in emphysematous pyelonephritis
		Diseases	Fever	Dysuria	Frequency	Dribbling	Hesitancy	Nocturia	Suprapubic tenderness	Skin lesions	Other	CBC	Electrolytes	Urinalysis	Ultrasonography	CT scan	Other	Gold standard	Additional findings
		Vulvovaginitis	+	+	+	+	+	–	–
		Cervicitis	+	±	+	±	–	–	+
		Prostatitis	+	+	+	+	+	+	+
		Epididymoorchitis	+	+	–	+	–	–	–
Non-inflammatory	Anatomic	Urethral stricture	–
		Benign prostatic hyperplasia (BPH)	–	+	+	+	+	+	–
	Drug	Spermicides	–
		Cyclophosphamide	–	+
	Endocrine disorders	Atrophic vaginitis	–
		Endometriosis	–	+															Dysmenorrhea Dyspareunia Dyschezia
	Malignancy	Bladder cancer	–	–
		Vulvovaginal cancer	±	–
	Iatrogenic	Genitourinary instrumentation	+	–
		Pelvic irradiation	–
		Trauma	±	±