genitourinary disorders
Evaluation of the Urologic Patient
History in the Urologic Patient
Pain originating in the kidneys or ureters is usually vaguely localized to the flanks or lower back and may radiate into the ipsilateral iliac fossa, upper thigh, testis, or labium. Typically, pain caused by Urinary Calculi is colicky and may be prostrating; it is more constant if caused by infection. Acute Symptoms of bladder obstruction in men include urinary hesitancy, straining, decrease in force and caliber of the urinary stream, and terminal dribbling. Urinary Incontinence in Adults has various forms. Enuresis after age 3 to 4 years may be a symptom of urethral stenosis in girls, posterior urethral valves in boys, psychologic distress, or, if onset is new, infection. Pneumaturia (air passed with urine) suggests a vesicovaginal, vesicoenteric, or ureteroenteric fistula; the last 2 may be caused by diverticulitis, Crohn disease, abscess, or colon cancer. Pneumaturia could also be due to emphysematous pyelonephritis. 