Download 3-Urological History & Examination

Urological History & Examination
Dr. Abdelmoniem ElTraifi
History
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Personal Data ( Patient Demography)
• Name & File number ( Medical record number)
• Age
• Sex
• Religion
• Marital status
• Occupation
• Residence
• Date and Time
• Who gave the history?
Chief Complaint
Main Complaint
Complain Of ( C/O)
History of the presenting Symptom
Elaborate the symptom.
 Elaborate the system involved.
 What had been done for the patient?
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Common Urology Presentations
Pain
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Site
Onset
Character
Severity
Radiation
Associated Symptoms
Timing ( duration, course, pattern)
Exacerbating & Relieving Factors
Pain
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Renal
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Ureteric
Other causes of pain, Radiculitis
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Vesical Pain
 Prostatic pain
 Testicular
 Epididymal
 Back
Others related to stone pathology
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Passage of stone
 Previous Treatment for stones
 Haematuria
 Bronchial Asthma & Allergy
 Trauma
 LUTS
Lower Urinary Tract Symptoms
(LUTS)
Causes
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Males, according to age group
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Females, according to age group
Lower Urinary Tract Symptoms
(LUTS)
Voiding (Obstructive)
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Hesitancy
 Loss of force and decrease of caliber of the
stream.
 Straining for voiding
 Interruption of the urinary stream
 Terminal dribbling.
 Retention: acute and chronic
Storage (Irritaive)
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Frequency
 Nocturia
 Urgency
 Urge incontinence
Post void Symptoms
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Post void Dribbling
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Sense of residual urine
LUTS other important Points
History of
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DM
Urological intervention
CNS problems and symptoms
Haematuria
Previous urinary retention
Burning Micturation and Febrile UTI
Drugs intake
Constipation
Incontinence
True
 Stress
 Urge
 Paradox ( overflow, false)
 Enuresis
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Dysuria ( Burning urination)
Pneumaturia
Cloudy urine
Oligouria & Anuria
Urethral Discharge
Renal failure Symptoms
Haematuria
Haematuria
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Age
Residency.
Duration.
Occupation
Painless or painful
Timing of haematuria
Amount of bleeding
Clots and shape of clots
Trauma
Bleeding from other sites
Associated Symptoms urinary and Systemic
Bleeding disorders, SC, TB, Bilharzias & stone disease.
Family History of Malignancy or hematological disorders.
Drugs
Colored food or drinks.
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Smoking
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Scrotal conditions, swellings
Other genito-urinary masses
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Duration
How noticed?
Change
Disappear
Associated symptoms
Increased by cough etc
Heavy lifting
Chronic cough, constipation, urinary
symptoms.
 Other masses
Male
Sexual
Infertility
Disorders
Systemic Review
Fever, weight loss
 CNS
 Cardio, respiratory and vascular
 GI
 Locomotors
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Past History
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Dm, Hypertension
Bronchial Asthma
Bleeding disorders & Sickle cell disease
Transfusion
TB, Syphilis, Bilharzias
Passage of stones
Blood transfusion
Operations, Urological and non Urological, RTA
Family History
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Similar conditions
 DM, Hypertension
 Bleeding Disorders& Sickle cell disease
Social History & Habits
 Drug History and allergy
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Examination
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Pallor, Jaundice
 Loss of weigh, over weight
 Cervical Lymph nodes
Abdominal Examination
Kidneys
Urinary Bladder
Scrotal masses
Inspection
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Site
Size
Shape
Skin
Cough impulse
Palpation
 Temp.
 Tenderness
 Consistency
 Others according
to diagnosis
Genital Examination
Transillumination
Per- rectal Examination
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