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Urinary History

Urinary History . Haddy Cosh and Amy Wood. PC / HPC - Symptoms. PROSTATE Flow – Stop / Start? Hesitancy Terminal Dribbling Haematuria. PENIS Discharge ( tell me about it ) Smelly Itchy Blisters Warts. BLADDER Incontinence Frequency (discuss normal) Urgency

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Urinary History

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  1. Urinary History Haddy Cosh and Amy Wood

  2. PC / HPC - Symptoms • PROSTATE • Flow – Stop / Start? • Hesitancy • Terminal Dribbling • Haematuria • PENIS • Discharge (tell me about it) • Smelly • Itchy • Blisters • Warts BLADDER • Incontinence • Frequency (discuss normal) • Urgency • Pain – renal colic, suprapubic, loin • Nocturia (sign of enlarged prostate) • Terminal Dribbling • Incomplete voiding – Does it feel empty when you’ve been?

  3. Associated symptoms • Fever • Confusion • Rigors • Sores Red Flags • Bone Pain • Back pain • Weight Loss • Appetite loss • Night sweats • Haematuria = Prostate Cancer unless proven otherwise

  4. Sexual History • How do you introduce the concept? • Do you mind if I ask you some personal questions? I have to ask everyone who comes in with your symptoms.. • Are you sexually active? (If not, ask “do you mind if I ask why”.. Impotence) • Ask about the 5 P’s: • Partners • Practices • Protections • Past history • (Pregnancy)

  5. Partners: • Do you have a regular partner? (Don’t assume M/F) How many partners in the last 5 Years? Is the partner experiencing any symptoms? • Practices: • What sort of sex is it? • Protection: • Do you use protection? Clarify how!! • Past history: • Have you ever had a Sexually Transmitted Infection / visited a GUM clinic? • Have you ever paid someone for sex?

  6. PMH • Recent hospital visits- catheter? • Diabetes (impotence & increased risk of infection) • Hypertension • Trauma • MS

  7. DH • Oxybutynin (Antimuscarininc reduces urgency and incontinence) • Diuretics • Digoxin (Renal excretion -dose dependent on renal function) • Lithium (Renal excretion) • Opioids (effects on excretion of water and sodium) • B – blockers (Renal excretion) • ACE inhibitors (Cause increased renal blood flow and promote salt excretion) • NSAIDs (Renal Excretion) • + Allergies

  8. Finishing off the history • SH • Factory worker? • Paid for sex? • Abroad (Schistomasis) • Smoking / Alcohol • Systems Review FH • Kidney disease • Diabetes

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