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How to diagnose Urologic Disorders

dr. Arnold Simandjuntak,Sp.U. How to diagnose Urologic Disorders. History Taking Age Work at..... Retired from..... - tire - plastic - - carcinogenic material - tar Women : - marital status : - how long -number of children

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How to diagnose Urologic Disorders

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  1. dr. Arnold Simandjuntak,Sp.U. How to diagnose Urologic Disorders

  2. History Taking Age Work at..... Retired from..... - tire - plastic - - carcinogenic material - tar Women : - marital status:-how long -number of children -age of children - labor status : -catherization -forceps -penneal fear Catamenia : -menarche -climacterium -menopause

  3. Pain Fever Mass Bloody urine Hesitancy Weak urinary stream Incontinence Urethral discharge Smoking (too much) Infertility Physical weakness Frequency Trauma Dysuria Dribbling Enuresis Flank discomfort Congenital anomalies Sexual dysfunction Urine retention Chief Complain :something that makes a patient goes to doctorFor example:

  4. Previous disease and history of family illness: • Veneral disease • Diabetes • Tubercolose • Bouginage • Urogenital trauma • Surgery • Menstrual Cycle (women) • Tropical / hot climate country (stone disease) • Imported disease (Schistosomiasis) B. Urologic physical examinations B. Urologic physical examinations B. Urologic physical examinations B. Urologic physical examinations

  5. B. Urologic physical examinations General condition : a. Don’t be hurry b. Check every system & organ systematically (not only urogenital organ) c. Observe the patient when he/she comes to the examination room: - normal walk - assisted - on wheel chair - crooked d. Exam : - vital sign - wasting/reduction of body weight - tension, depression, pale, painful Abdominal examination : Liver & Spleen Kidney Suprapubic area Groin/Inguinal area External Genital Organ : Men : Penis & Scrotum Women : Vulvus & Urethra

  6. 4. Digital Rectal Examination (DRE) - Perianal Region - Sphinter ani tones - Rectal ampoule - Surface of the mucosal rectum - Prostate (male):- symetric - upper part - consistency - nodule - pain - gloves - Reflex bulbocavernosus

  7. C. Laboratory examinations URINE : - How to catch urine - Macroscopic examination - Color & appereance - Chemical test: - pH - protein - glucose - hemoglobine - bacterial & leucocyte - Microscopic urinalysis: - staining - erythrocytes - leucocytes - casts - epithelial cell - culture & resistency test - Cytology of the urine

  8. BLOOD :- Kidney function : Ureum, Creatinine - Tumor marker : BTA, PSA

  9. D. Imaging X ray : KUB, IVP, RPG, APG USG USG Doppler CT Scan MRI PET Scan Arteriography (not anymore)

  10. Conclusion • The same procedure with the other disease to find a diagnosis of the urologic disorder. • Consist of : History, Physical exam, Lab, Imaging • Always in our mind : 60-70% diagnosis is based on history • The sophisticated equipment is only a compliment

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