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Is there fever? A significant fever would suggest either pyelonephritis, particularly in females, or acute prostatitis in males.
Is the urine grossly bloody or are there a significant number of red cells on microscopic ... DIAGNOSTIC WORKUP
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Is it transient? Migraine, asthma, and drugs such as diuretics may produce transient polyuria.
Is it massive? Massive polyuria is usually due to pituitary or nephrogenic diabetes insipidus and ... DIAGNOSTIC WORKUP
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Are there significant numbers of white blood cells (WBCs) in the urine? This would suggest a UTI. If there are white cell casts or clumps, the infection may be a pyelonephritis. A urine culture and colony count should be ordered. Sterile ... DIAGNOSTIC WORKUP
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Are there significant RBCs in the urine? If so, one should consider glomerulonephritis, collagen disease, tuberculosis, neoplasm, trauma, renal calculus, and polycystic kidney disease. If not, the most ... DIAGNOSTIC WORKUP
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Has the patient been on any drugs? Sulfonamides are notorious for causing renal failure, but one must also consider amphotericin B, gold compounds that might be administered in arthritis, and lead and other drugs or heavy metals.
What is the ... DIAGNOSTIC WORKUP
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Dysuria is a painful or burning sensation during or immediately after urination. This is a common symptom in primary care; nearly 20% of women aged 20–55 will have one episode of dysuria per year. Women have episodes of acute dysuria much more frequently... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Polyuria is defined as urine output greater than 3 L per day. The output of a large volume of dilute urine leads to extracellular dehydration, which stimulates the thirst centers to influence the patient to increase fluid intake; thus, this condition may also... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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A perceived or observed decrease in the strength or flow of one's urine stream is a common complaint. This is often of concern to the patient because of the concern about both a serious medical problem and the slowing of urination and associated dribbling or... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Dysuria is defined as pain with urination and is a very common complaint in female children. It is commonly due to either urinary tract infection or perineal irritation from a variety of causes.
Differential Diagnosis
... Workup and Diagnosis ... Treatment
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Proteinuria in children is defined as a quantitative 24-hour urine collection with >4 mg/m2/hour (>100 mg/m2/day) of protein. Semiquantitative definitions include urine dipstick ≥1+ (30 mg/dL) for specific gravity (SG) ≤1.015, or... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Pyuria is defined as the presence of white blood cells in the urine. This condition is commonly caused by urinary tract infection, asymptomatic bacteriuria, or vaginal contamination of the urine specimen.
Differential Diagnosis
... Workup and Diagnosis ... Treatment
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... Dysuria is difficult or painful micturition. One could cover most of the causes simply by considering the inflammatory lesions of the genitourinary tract in ascending order. Thus, there may be a urethritis or urethral carbuncle, a trigonitis or prostatitis,
... READ EXCERPTS »
... Polyuria is an absolute increase in the urine output in a 24-hour period. The average individual excretes 1,500 mL of urine a day. Many physiologic conditions increase the output of urine (stress, exercise, and warm weather associated with copious drinking). From a
... READ EXCERPTS »
... There are many causes of proteinuria. The mnemonic VINDICATE is a helpful way of developing a list of possibilities.
PROTEINURIA
V—Vascular category should call to mind CHF,
... READ EXCERPTS »
... Pyuria is included here although it is not a symptom or a definitive finding on physical examination. Examination of the urine, however, is so frequently a part of every physical examination that the causes of pyuria should be available for immediate
... READ EXCERPTS »
... Incontinence may be due to loss of voluntary control of urination, in which case neurologic disorders are usually the cause, or it may result from overflow of a distended bladder (overflow incontinence), in which case the cause may be bladder neck
... READ EXCERPTS »
...
ANURIA AND OLIGURIA
ANURIA AND OLIGURIA
Diminished output of urine (oliguria with less than 500 mL output in 24 hours) and no output
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... A cardinal sign of renal and urinary tract disorders, oliguria is clinically defined as urine output of less than 400 ml/24 hours. Typically, this sign occurs abruptly and may herald serious — possibly life-threatening — hemodynamic... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... A relatively common sign, polyuria is the daily production and excretion of more than 3 L of urine. It’s usually reported by the patient as increased urination, especially when it occurs at night. Polyuria is aggravated by overhydration, consumption of caffeine or alcohol,... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... Urinary frequency refers to increased incidence of the urge to void without an increase in the total volume of urine produced. Usually resulting from decreased bladder capacity, frequency is a cardinal sign of urinary tract infection. However, it can... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers
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... Hesitancy — difficulty starting a urine stream generally followed by a decrease in the force of the stream — can result from a urinary tract infection, a partial lower urinary tract obstruction, a neuromuscular disorder, or use of certain... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Incontinence, the uncontrollable passage of urine, can result from a bladder abnormality, a neurologic disorder, or an alteration in pelvic muscle strength. A common urologic sign, incontinence may be transient or permanent and may involve large volumes of urine or... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... A sudden compelling urge to urinate, accompanied by bladder pain, is a classic symptom of urinary tract infection (UTI). As inflammation decreases bladder capacity, discomfort results from the accumulation of even small amounts of urine. Repeated, frequent voiding in an effort to... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Cloudy, murky, or turbid urine reflects the presence of bacteria, mucus, leukocytes or erythrocytes, epithelial cells, fat, or phosphates (in alkaline urine). It’s characteristic of urinary tract infection (UTI) but can also result from prolonged storage of a urine specimen at... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers
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... Central diabetes insipidus
Renal disease
Nephrogenic diabetes insipidus, congenital
Chronic renal insufficiency (especially tubulointerstitial
... READ EXCERPTS »
... Benign/Physiologic
Fever
Exercise
Orthostatic
Contrast dye
Usually Nonnephritic
Chronic pyelonephritis
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... Urethral
Congenital urethral stenosis, web, atresia
Posterior urethral valves
Inflammation or stricture
Trauma
Bladder Neck
Prostatic hypertrophy,
... READ EXCERPTS »
... Cystitis and urethritis, the two forms of lower urinary tract infection (UTI), are nearly 10 times more common in females than in males and affect approximately 10% to 20% of all females at least once. Lower UTI is also a prevalent bacterial disease in children, with females again most... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Dysuria—painful or difficult urination—is commonly accompanied by urinary frequency, urgency, or hesitancy. This symptom usually reflects lower urinary tract infection (UTI)—a common disorder, especially in women. (See ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Geriatric pointers ... Pictures
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... A cardinal sign of renal and urinary tract disorders, oliguria is clinically defined as urine output of less than 400 ml/24 hours. Typically, this sign occurs abruptly and may herald serious—possibly life-threatening—hemodynamic instability. Its causes can be classified... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... A relatively common sign, polyuria is the daily production and excretion of more than 3 L of urine. It’s usually reported by the patient as increased urination, especially when it occurs at night. Polyuria is aggravated by overhydration, consumption of caffeine or... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... Urinary frequency refers to an increased urge to void without an increase in the total volume of urine produced. Usually resulting from decreased bladder capacity, urinary frequency is a cardinal sign of urinary tract infection (UTI). However, it can also stem from another... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling
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... Urinary hesitancy—difficulty starting a urine stream generally followed by a decrease in the force of the stream—can result from a urinary tract infection (UTI), a partial lower urinary tract obstruction, a neuromuscular disorder, or use of certain drugs. Occurring at all... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Incontinence, the uncontrollable passage of urine, can result from a bladder abnormality, a neurologic disorder, or an alteration in pelvic muscle strength. A common urologic sign, incontinence may be transient or permanent and may involve large volumes of urine or scant dribbling. It... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... A sudden compelling urge to urinate accompanied by bladder pain is a classic symptom of urinary tract infection (UTI). As inflammation decreases bladder capacity, discomfort results from the accumulation of even small amounts of urine. Frequent voiding in an effort to alleviate... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling
... READ EXCERPTS »
... Cloudy, murky, or turbid urine reflects the presence of bacteria, mucus, leukocytes or erythrocytes, epithelial cells, fat, or phosphates (in alkaline urine). It’s characteristic of urinary tract infection (UTI), but it can also result from prolonged storage of a urine specimen at... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers
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... David M. Quillen
Approach Dysuria is defined as “painful urination.” Acute dysuria is a frequent problem seen in ambulatory practices, accounting for more than three million office visits a year. The most... History ... Physical examination ... Testing ... Diagnostic assessment
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... Irene M. Hamrick
The prevalence of proteinuria in the general population is 3%, and 5% in healthy adolescents (1). Heavy and persistent proteinuria is associated with the development of end-stage renal disease in patients with glomerular pathology
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... Richard Rathe
Urinary incontinence (UI) in adults is one of the most prevalent and underdiagnosed afflictions in the United States (>25 million effected individuals, >50% of nursing home residents). The economic impact is... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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... Marcia W. Funderburk
Oliguria and anuria are important clinical signs that should be recognized quickly so that the cause can be identified and treatment initiated promptly to preserve renal function and prevent life-threatening... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
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... Differential Overview
❑ Lower urinary tract infection
❑ Acute pyelonephritis
❑ Urethritis
❑ Vaginitis
❑ Acute... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
❑ Urinary tract infection
❑ Diabetes mellitus
❑ Diuretic therapy
❑ Bladder outlet obstruction ... Diagnostic Approach ... Clinical Findings
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... Differential Overview
❑ Diabetes
❑ Drugs/toxins
❑ Acute tubular necrosis
❑ Glomerulonephritis ... Diagnostic Approach ... Clinical Findings
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... Differential Overview
❑ Cystitis
❑ Benign prostatic hypertrophy
❑ Pelvic floor relaxation
❑ Drugs
❑ Prostatitis
&... Diagnostic Approach ... Clinical Findings
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... Differential Overview
❑ Acute tubular necrosis
❑ Prerenal azotemia
❑ Tubular toxins
❑ Bladder outlet obstruction
❑ Bilateral renal... Diagnostic Approach ... Clinical Findings
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... Cystitis and urethritis, the two forms of lower urinary tract infection (UTI), are nearly 10 times more common in women than in men and affect approximately 10% to 20% of all women at least once. Lower UTI is also a prevalent bacterial disease in children, with girls also most... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
... READ EXCERPTS »
... Dysuria (painful or difficult urination) is commonly accompanied by urinary frequency, urgency, or hesitancy. This symptom usually reflects lower urinary tract infection (UTI) — a common disorder, especially in women.
Dysuria also results... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Geriatric pointers ... Patient counseling ... Pictures
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... A cardinal sign of renal and urinary tract disorders, oliguria is clinically defined as urine output of less than 400 ml/24 hours. Typically, this sign occurs abruptly and may herald serious — possibly life-threatening — hemodynamic instability. Its causes can be classified as... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... A relatively common sign, polyuria is the daily production and excretion of more than 3 L of urine. It’s usually reported by the patient as increased urination, especially when it occurs at night. Polyuria is aggravated by overhydration, consumption of... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Urinary frequency refers to increased incidence of the urge to void without an increase in the total volume of urine produced. Usually resulting from decreased bladder capacity, urinary frequency is a cardinal sign of urinary tract infection (UTI). (See Associated disorder:... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Urinary hesitancy — difficulty starting a urine stream generally followed by a decrease in the force of the stream — can result from a urinary tract infection (UTI), a partial lower urinary tract obstruction, a neuromuscular disorder,... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Incontinence, the uncontrollable passage of urine, can result from a bladder abnormality, a neurologic disorder, or an alteration in pelvic muscle strength. A common urologic sign, incontinence may be transient or permanent and may involve large... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... A sudden compelling urge to urinate, accompanied by bladder pain, is a classic symptom of urinary tract infection (UTI). As inflammation decreases bladder capacity, discomfort results from the accumulation of even small amounts of urine. Repeated, frequent... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
...Dysuria (pain on urination) is usually producedby inflammation of urethra or bladder or both. Principal Causes of Dysuria Urinarytract infection Urethritis Cystitis Pyelonephritis Chemical irritation Diaper dermatitis ... Clinical Features and Diagnosis ... Diagnostic Approach ... Table 15.1. Criteria for Diagnosis of Urinary Tract Infections ... References
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... Proteinuriais a common finding in childhood and adolescence. Usual pathogenesis involves increasein permeability of glomerular basement membrane. Less common isdecreased absorption or increased secretion of protein by renaltubules, which may occur with... Principal Causes of Proteinuria ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... Urinaryincontinence or enuresis refers to the involuntary passage of urine. Most children have achieved urine continenceduring the day by 4 yrs of age, and during the night by 6 yrs ofage. Primary incontinence exists when achild has never gained bladder control... Principal Causes of Urinary Incontinence ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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...Polyuria (excessive urine volume) is usuallyassociated with polydipsia (excessive thirst). Principal Causes of Polyuria and Polydipsia Diabetesmellitus Diabetes insipidus Antidiuretichormone deficiency (central diabetes insipidus) ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... Dysuria—painful or difficult urination—is commonly accompanied by urinary frequency, urgency, or hesitancy. This symptom usually reflects lower urinary tract infection (UTI)—a common disorder, especially in women.
Dysuria results from lower urinary tract... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... A cardinal sign of renal and urinary tract disorders, oliguria is clinically defined as urine output of less than 400 ml/24 hours. Typically, this sign occurs abruptly and may herald serious—possibly life-threatening—hemodynamic instability... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... A relatively common sign, polyuria is the daily production and excretion of more than 3 L of urine. It's usually reported by the patient as increased urination, especially when it occurs at night. Polyuria is aggravated by overhydration,... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... Urinary frequency refers to increased incidence of the urge to void without an increase in the total volume of urine produced. Usually resulting from decreased bladder capacity, frequency is a cardinal sign of urinary tract infection. However, it can also stem from another... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... Hesitancy—difficulty starting a urine stream generally followed by a decrease in the force of the stream—can result from a urinary tract infection (UTI), a partial lower urinary tract obstruction, a neuromuscular disorder, or use of certain drugs.... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... Urinary incontinence, the uncontrollable passage of urine, can result from a bladder abnormality, a neurologic disorder, or an alteration in pelvic muscle strength. A common urologic sign, incontinence may be transient or permanent and may involve large volumes of urine or scant... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... A sudden compelling urge to urinate (urinary urgency), accompanied by bladder pain, is a classic symptom of a urinary tract infection (UTI). As inflammation decreases bladder capacity, discomfort results from the accumulation of even small amounts of urine. Repeated,... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Cloudy, murky, or turbid urine reflects the presence of bacteria, mucus, leukocytes or erythrocytes, epithelial cells, fat, or phosphates (in alkaline urine). It's characteristic of urinary tract infection (UTI) but can also result from prolonged storage... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
...
Dysuria is difficult or painful micturition. One could cover most of
the causes simply by considering the inflammatory lesions of the
genitourinary tract in ascending order. Thus, there may be a urethritis or ... Pictures
... READ EXCERPTS »
...
Polyuria is an absolute increase in the urine output in a 24-hour
period. The average individual excretes 1,500 mL of urine a day. Many
physiologic conditions increase the output of urine (stress, exercise, and
warm weather associated with... Pictures
... READ EXCERPTS »
...
There are many causes of proteinuria. The mnemonic VINDICATE is a
helpful way of developing a list of possibilities.
V—Vascular category should call to mind CHF, hypertension, and
renal vein thrombosis.
I—Inflammation. An... Pictures
... READ EXCERPTS »
...
Pyuria is included here although it is not a symptom or a definitive
finding on physical examination. Examination of the urine, however, is so
frequently a part of every physical examination that the causes of pyuria
should be... Pictures
... READ EXCERPTS »
...
Incontinence may be due to loss of voluntary control of urination, in
which case neurologic disorders are usually the cause, or it may result from
overflow of a distended bladder (overflow incontinence), in which case the
cause may be bladder neck
... READ EXCERPTS »
...
Diminished output of urine (oliguria with less than 500 mL of output in
24 hours) and no output of urine (anuria) are best understood using
pathophysiology. The causes may be divided into prerenal (where less fluid
is delivered to... Pictures
... READ EXCERPTS »
... Mercedes M. Blackstone, MDKathy N. Shaw, MD, MSCE Urinary Tract Infection - BASICS Urinary Tract Infection - description UTI is growth of bacterial urinary tract pathogen(s):For suprapubic ... Urinary Tract Infection - DIAGNOSIS ... Urinary Tract Infection - TREATMENT ... Urinary Tract Infection - FOLLOW UP ... Urinary Tract Infection - bibliography ... Urinary Tract Infection - CODES ... Urinary Tract Infection - FAQ
... READ EXCERPTS »
... Etiology
Pediatric urinary tract infection begins with colonization of the periurethral
area with gastrointestinal bacteria. These bacteria may then ascend into the
bladder, kidneys, or both. A variety of virulence factors may promote infection
with certain... Presentation ... Diagnosis ... Management of Urinary Tract Infection ... Radiographic Evaluation after Urinary Tract Infection
... Management of Vesicoureteral Reflux ... Selected Readings ... Pictures
... READ EXCERPTS »
Chlamydia is often refered to, and joked about, as "the clap". But for the 3 million people who are infected with it each year in the U.S. alone,...
When people start having the symptoms of urinary incontinence, they're often too embarrassed to talk about it, even with their doctors. But...
Urinary incontinence is an embarrassing and frustrating problem that affects millions of adults in the United States. Many think it's just a...
It's no secret that our bodies change as we age, and some adjustments are unavoidable. But urinary incontinence is one problem older people...