Urologic evaluation
A-History: Patient age, sex&marital status. Complaint: in a chronological order. Present history: -details of the complains and its course and treatment received. -Stones, operations. -Diseases eg:TB, Bilharziasis and systemic diseases as diabetes, hypertension, heart disease and treatment received. -Drugs eg: corticosteroids, anticoagulants (stop before surgery) and antihypertensives. B-General examination. C- Local examination. D- Provisional diagnosis: Anatomical: involved organ or system. Pathological. In any case, the diagnosis should be categorized under one of these categories: - Congenital or - Acquired: Traumatic, infection (acute or chronic), neoplastic, others as hydronephrosis. Common complains in urology are: 1-Lower urinary tract symptoms. 2- Upper urinary tract symptoms. 1-Lower urinary tract symptoms: A) Obstructive symptoms: Hesistancy. Poor or weak flow. Intermittency. Terminal dribbling. b) Irritative symptoms: - Urgency. - Frequency. - Nocturia. 2-Incontience.
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3-Haematuria 4-Renal colic. 5-Anuria. 6-Male sexual dysfunction (Impotence, premature ejaculation,inability to ejaculate). Local examination: 1-Renal swelling: Common causes are: - Hydronephrosis. - Polycystic kidney. - Tumour. - Perirenal haematoma. - Large renal cyst. - Pyonehrosis. Characteristic features of renal swelling: - Intra abdominal. - Mobile with respiration. - Direction of enlargement downward,rarely crosses the mid line(very large hydronephrosis) - Fills the renal angle by palpation. - Band of resonance in front. - Renal angle is dull on percussion. 2-Bladder swelling: Acute and chronic urine retention. Characteristics: - Intra abdominal swelling. - Globular - Pelvi-abdominal(you can not get below it) - By manually palpable mass(by PR+abdominal examination)