Dysuria resident survival guide

Dysuria Resident Survival Guide
Overview
Causes
Diagnosis
Treatment
Do's
Don'ts

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Iqra Qamar M.D.[2] Rinky Agnes Botleroo, M.B.B.S.

Overview

This section provides a short and straight to the point overview of the disease or symptom. The first sentence of the overview must contain the name of the disease.

Causes

Life Threatening Causes

Life-threatening causes of dysuria include

• Stevens–Johnson syndrome
• Toxic epidermal necrolysis

These conditions may result in death or permanent disability within 24 hours if left untreated

Common Causes

• Acute Cystitis
• Urethritis from sexually transmitted infections
  • Gonorrhea
  • Chlamydia
  • Trichomoniasis
• Female genital structure related
  • Vulvo-Vaginitis
    • Trichomoniasis
    • Bacterial vaginosis
    • Candidal infections
    • Atrophic vaginitis
  • Cervicitis
  • Pelvic Inflammatory Disease
• Male genital Structure related
  • Balanitis
  • Prostatitis
  • Epididymo-orchitis
  • Benign prostatic hyperplasia
• Foreign Body in urinary tract
  • Indwelling Foley catheter
  • Stone
  • Urethral or ureteral stent
• Pyelonephritis
• Urethral Stricture
• Dermatological
  • Herpes
  • Irritant dermatitis
  • Erosive lichen planus
  • Contact Dermatitis
• Local trauma
• Medication use
  • Cyclophosphamide
• Neoplasia
  • Bladder Carcinoma
  • Renal Cell Carcinoma

Diagnosis

Shown below is two algorithms summarizing the diagnosis of Dysuria

Algorithm showing diagnosis of dysuria in woman

Woman with dysuria

Take complete history

Presence of Comcomitant fever,flank pain, abnormal vital signs(Tachycardia,Tachypnea,Hypotension),nausea,vomiting

Yes

No

Refer to ER

Urine Dipstick for Nitrites and Leukocytes

Nitrite Postitive

Leukocytes positive,Nitrite negative

Both Nitrite and Leukocyte negative

Urine culture

Empirical Antibiotic Therapy

Urine Culture

Positive

Negative

Specific Antibiotic

Postive

Negative

Urethral discharge/Itching

Acid urine pH/history of TB

Specific antibiotic

Swab

Urine speicific test for Tuberculosis

Algorithm showing diagnosis of dysuria in Male patients

Male patient with dysuria

Take complete history

Presence of urethral discharge

Yes

No

Ask about the discharge

Presence Of Genital Lesion

YES

NO

Profuse,purulent discharge Yellowish green colour

Thin,mucoid/mucopurulent discharge

SMEAR

SMEAR

FINDING

FINDING

GONORRHOEA

CHLAMYDIA

Inflammation of the glans

Ulcer

Painful Vesicles

Balanitis

Herpes

1ST FINDIND

2ND FINDING

Syphilis

LGV

Any Localized Pain

YES

No

Suprapubic pain

Flank pain Costovertebral angle tenderness Fever

Joint pain

Urine Analysis

USG

Dx test

Cystitis

Spondyloarthropathy

Treatment

Shown below is an algorithm summarizing the treatment of [[disease name]] according the the [...] guidelines.

Do's

• The content in this section is in bullet points.

Don'ts

• The content in this section is in bullet points.

References

Template:WikiDoc Sources