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A2. Symptoms of disorders of the genitourinary tract and differential diagnosis
- Urologic symptoms are generally
- Pain, discomfort
- Alterations of urination
- Changes in the gross appearance of the urine
- Abnormal appearance or function of external genitalia
- Primary urologic diseases can manifest as GI problems
- Systemic manifestations
- Fever
- Acute pyelonephritis, prostatitis, RCC
- Chronic pyelonephritis does not cause fever
- Weight loss
- Advanced stages of cancer
- Pain
- Can be felt locally at the area of the diseased organ or elsewhere, as referred pain
- Renal pain
- Either dull and aching or sharp and colicky (renal colic)
- Dull and aching renal pain
- Usually felt at the costovertebral angle
- Pyelonephritis
- Renal colic
- Severe, unilateral colicky flank pain
- Paroxysmal
- The patient has a severe urge to move around
- Can radiate to groin, perineum, abdomen, etc.
- Painful on percussion
- Nausea, vomiting common
- Due to ureter or kidney stone
- Ureteral pain
- Typically caused by acute obstruction and distension of the ureter
- Ureter pain is felt at the area of the kidney, but may radiate to the groin
- Bladder pain
- Acute distension -> overdistension -> discomfort in suprapubic area
- Dysuria = painful urination
- In case of lower urinary tract infection (cystitis or urethritis)
- Cystitis -> sharp, burning pain in urethra or penis
- Pain at the end of urination is typical symptom of cystitis
- Prostate pain
- Discomfort in perineal or rectal area -> prostatitis
- Testicular/scrotal pain
- Usually due to disease of testis or epididymis, but kidney or ureter stone can cause testicular pain
- Sudden, severe pain
- Trauma
- Epididymitis
- Testicular torsion
- Kidney or ureter stone
- Less severe pain, insidious onset
- Urethral discharge -> STD
- Eneuresis = wetting the bed at night
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