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Urinary History . Haddy Cosh and Amy Wood. PC / HPC - Symptoms. PROSTATE Flow – Stop / Start? Hesitancy Terminal Dribbling Haematuria. PENIS Discharge ( tell me about it ) Smelly Itchy Blisters Warts. BLADDER Incontinence Frequency (discuss normal) Urgency

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Urinary History


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urinary history

Urinary History

Haddy Cosh and Amy Wood

pc hpc symptoms
PC / HPC - Symptoms
  • PROSTATE
  • Flow – Stop / Start?
  • Hesitancy
  • Terminal Dribbling
  • Haematuria
  • PENIS
  • Discharge (tell me about it)
  • Smelly
  • Itchy
  • Blisters
  • Warts

BLADDER

  • Incontinence
  • Frequency (discuss normal)
  • Urgency
  • Pain – renal colic, suprapubic, loin
  • Nocturia (sign of enlarged prostate)
  • Terminal Dribbling
  • Incomplete voiding – Does it feel empty when you’ve been?
slide3

Associated symptoms

  • Fever
  • Confusion
  • Rigors
  • Sores

Red Flags

  • Bone Pain
  • Back pain
  • Weight Loss
  • Appetite loss
  • Night sweats
  • Haematuria = Prostate Cancer unless proven otherwise
sexual history
Sexual History
  • How do you introduce the concept?
  • Do you mind if I ask you some personal questions? I have to ask everyone who comes in with your symptoms..
  • Are you sexually active? (If not, ask “do you mind if I ask why”.. Impotence)
  • Ask about the 5 P’s:
  • Partners
  • Practices
  • Protections
  • Past history
  • (Pregnancy)
slide5

Partners:

  • Do you have a regular partner? (Don’t assume M/F) How many partners in the last 5 Years? Is the partner experiencing any symptoms?
  • Practices:
  • What sort of sex is it?
  • Protection:
  • Do you use protection? Clarify how!!
  • Past history:
  • Have you ever had a Sexually Transmitted Infection / visited a GUM clinic?
  • Have you ever paid someone for sex?
slide6
PMH
  • Recent hospital visits- catheter?
  • Diabetes (impotence & increased risk of infection)
  • Hypertension
  • Trauma
  • MS
slide7
DH
  • Oxybutynin (Antimuscarininc reduces urgency and incontinence)
  • Diuretics
  • Digoxin (Renal excretion -dose dependent on renal function)
  • Lithium (Renal excretion)
  • Opioids (effects on excretion of water and sodium)
  • B – blockers (Renal excretion)
  • ACE inhibitors (Cause increased renal blood flow and promote salt excretion)
  • NSAIDs (Renal Excretion)
  • + Allergies
finishing off the history
Finishing off the history
  • SH
  • Factory worker?
  • Paid for sex?
  • Abroad (Schistomasis)
  • Smoking / Alcohol
  • Systems Review

FH

  • Kidney disease
  • Diabetes