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Canterbury District Health Board Canterbury Regional Cancer and Haematology Service Oncology Service Telephone Triage symptom prompt sheet Dysuria NU10.01.08 Dysuria Definition Dysuria: painful or difficult urination Nocturia: excessive urination at night Haematuria: discharge of blood in the urine Potential causes Spinal cord compression, UTI, acute infection, chemotherapy, invasive pelvic procedures – TURP, cystoscopy, prostatectomy, radiation, brachytherapy. Symptom Assessment Onset, duration, current voiding pattern – frequency, urgency, hesitation? Time of last void and volume? Appearance of urine: colour, clarity, presence of blood, clots or debris? Usual voiding pattern? Any smell to urine? Presence of pain: location, description, duration? Recent procedures: catheters, surgery, radiation, chemotherapy (cyclophosphamide/ifosphamide)? Any other symptoms: fever, fatigue, dizziness, SOB, flank pain? Does sexual activity exacerbate the problem? How much fluid intake in last 24 hours? Insatiable thirst or diabetes? Any history of UTI’s? Date of last blood test, has a urine sample has been taken? Have other symptoms of spinal cord compression been excluded i.e. limb numbness, weakness, back pain, faecal incontinence. Measurement/Evaluation CTCAE Grading Guidelines 1 - 2 - Acute pain Incontinence Unable to void > 10 hours with normal fluid intake Frank bleeding Fever of 38OC or more VERY URGENT Author: Clinical Nurse Specialist Oncology Outpatient Dept. Doc Code: NU10.01.08 3 4 Urgency limiting instrumental ADL; medical management indicated Urinary urgency present Change in character of urine Minor changes in normal voiding pattern Consider MSU to exclude infection Urgent Non-Urgent Authorised By: Medical Oncology Clinical Director Issue: 2016 Issue: 0.1 Review due: February 2018 Page 1 of 2 Canterbury District Health Board Canterbury Regional Cancer and Haematology Service Requires immediate medical attention Author: Clinical Nurse Specialist Oncology Outpatient Dept. Doc Code: NU10.01.08 Oncology Service Telephone Triage symptom prompt sheet Dysuria Consult on call team/medical attention within 6-12 hours Authorised By: Medical Oncology Clinical Director Follow up within 24 hours, consider community provider support Issue: 2016 Issue: 0.1 Review due: February 2018 Page 2 of 2