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
		Urethritis	+	+	+	–	+	–	+	Keratoderma blennorrhagica- in disseminated gonococcal infection Vesicles - HSV Painless ulcer- syphilis Warts- Condyloma acuminatum	–	Leukocytosis	N
		Pyelonephritis	+	+	+	–	–	+	±	N	Urgency	Leukocytosis		WBC Leukocyte esterase Ntrite
		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	±	±