STUDY - Technical - New Dacian's Medicine
Dysuria
(Classical / Allopathic Medicine)
Dysuria - painful
or difficult urination - is commonly accompanied by urinary
frequency, urgency, or hesitancy. This symptom usually
reflects lower urinary tract infection - a common disorder,
especially in women.
Dysuria results
from lower urinary tract irritation or inflammation, which
stimulates nerve endings in the bladder and urethra. The
pain's onset provides clues to its cause - for example, the
pain just before voiding usually indicates bladder irritation
or distention, whereas pain at the start of urination
typically results from bladder outlet irritation. Pain at the
end of voiding may signal bladder spasms; in women, it may
indicate vaginal candidiasis.
HISTORY:
Ask the patient when he first noticed the dysuria. Did anything precipitate it?
Ask the patient to describe the dysuria's severity and location. Does anything aggravate or alleviate it?
Review the patient's history for urinary or genital tract infections, intestinal disease, or a recent invasive procedure, such as cystoscopy or urethral dilatation.
If the patient is female, ask her about menstrual disorders and the use of products that irritate the urinary tract, such as bubble bath salts, feminine deodorants, contraceptive gels, or perineal lotions. Also, ask her about vaginal discharge or pruritus.
Ask the patient when he first noticed the dysuria. Did anything precipitate it?
Ask the patient to describe the dysuria's severity and location. Does anything aggravate or alleviate it?
Review the patient's history for urinary or genital tract infections, intestinal disease, or a recent invasive procedure, such as cystoscopy or urethral dilatation.
If the patient is female, ask her about menstrual disorders and the use of products that irritate the urinary tract, such as bubble bath salts, feminine deodorants, contraceptive gels, or perineal lotions. Also, ask her about vaginal discharge or pruritus.
PHYSICAL
ASSESSMENT:
Take the patient's vital signs. Note increased temperature, if present.
Inspect the abdomen. Palpate the abdomen for distention and tenderness. Note bladder distention, if present.
Inspect the urethral meatus for discharge, irritation, or other abnormalities.
Take the patient's vital signs. Note increased temperature, if present.
Inspect the abdomen. Palpate the abdomen for distention and tenderness. Note bladder distention, if present.
Inspect the urethral meatus for discharge, irritation, or other abnormalities.
SPECIAL
CONSIDERATIONS:
Monitor vital signs, intake, and output. Administer prescribed drugs, and prepare the patient for such tests as urinalysis and cystoscopy.
Monitor vital signs, intake, and output. Administer prescribed drugs, and prepare the patient for such tests as urinalysis and cystoscopy.
AGING ISSUES:
Be aware that elderly patients tend to underreport their symptoms even though older men have an increased incidence of non–sexually related urinary tract infections and postmenopausal women have an increased incidence of noninfectious dysuria.
Be aware that elderly patients tend to underreport their symptoms even though older men have an increased incidence of non–sexually related urinary tract infections and postmenopausal women have an increased incidence of noninfectious dysuria.
PATIENT
COUNSELING:
Teach a female patient (or her parents) that the perineum should be wiped from front to back after urination and defecation to prevent contamination with fecal material. Also, instruct the patient that feminine deodorants, douches, bubble baths, and similar irritants may cause dysuria.
Teach a female patient (or her parents) that the perineum should be wiped from front to back after urination and defecation to prevent contamination with fecal material. Also, instruct the patient that feminine deodorants, douches, bubble baths, and similar irritants may cause dysuria.
Bibliography:
1. Rapid Assessment, A
Flowchart Guide to Evaluating Signs & Symptoms, Lippincott
Williams & Wilkins, 2004.
2. Professional Guide to
Signs and symptoms, Edition V, Lippincott
Williams & Wilkins, 2007.
3. Guide to common
symptoms, Edition V, McGraw - Hill, 2002.
Dorin,
Merticaru (2010)