genitourinary disorders
Urinary Frequency
Evaluation of Urinary Frequency
 should first ask about the amounts of fluid consumed and voided to distinguish between urinary frequency and Polyuria . If urinary frequency is present, patients are asked about acuity of onset, presence or absence of irritative symptoms (eg, irritation, urgency, should cover symptoms suggestive of a cause, including fever, flank or groin pain, and hematuria (infection); missed menses, breast swelling, and morning sickness (pregnancy); and arthritis and conjunctivitis ( Reactive Arthritis ). Past medical historyshould ask about known causes, including prostate disease and previous pelvic radiation therapy or surgeries. Drugs and diet are reviewed for the use of agents that increase urine output (eg, diuretics, alcohol, caffeinated beverages). Examination focuses on the genitourinary system. Any urethral discharge or any lesions consistent with Overview of Sexually Transmitted Infections are noted. Rectal examination in men should note the size and consistency of the prostate and rectal tone; pelvic examination in women should note the presence of any The costovertebral angle should be palpated for tenderness, and the abdominal examination should note the presence of any masses or suprapubic tenderness. Neurologic examination should test for lower-extremity weakness and loss of sensation. The following findings are of particular concern: Lower-extremity weakness or signs of spinal cord damage (eg, loss of sensation at a segmental level, loss of anal sphincter tone and anal wink reflex) Fever and back pain Dysuria suggests frequency is due to All patients require urinalysis and culture, which are easily done and can detect infection and Isolated Hematuria . Cytoscopy, cystometry, and urethrography can be done to diagnose cystitis, bladder outlet obstruction, and Anterior and Posterior Vaginal Wall Prolapse . 