Lower urinary tract symptoms

Published on 09/03/2015 by admin

Filed under Obstetrics & Gynecology

Last modified 09/03/2015

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Chapter 17 Lower urinary tract symptoms

Urinary incontinence is the complaint of involuntary urinary leakage. Lower urinary tract symptoms include complaints regarding urinary storage, voiding or postmicturition symptoms. When a woman presents with urinary symptoms, a detailed history on lower urinary tract symptoms is required.

History

• daytime frequency (normally up to 8 times a day): increased frequency is associated with increased fluid intake, detrusor overactivity, poor bladder compliance or increase in bladder sensation

• nocturia: waking up to pass urine

• urinary urgency: sudden desire to pass urine, which is difficult to defer

• urinary stress incontinence: involuntary leakage on effort or exertion

• urinary urge incontinence: involuntary leakage accompanied by urgency

• may present with frequent losses or large leakage

• commonly associated with ‘triggers’ causing urgency and incontinence (e.g. turning on taps, coming home with ‘key-in-the-door’)

• continuous leakage

• voiding problems

• slow stream

• straining to void: effort required to initiate, maintain or improve urinary flow

• intermittent flow

• hesitancy: difficulty in initiating micturition

• postmicturition

• sensation of incomplete emptying

• postvoid dribble: leaking after voiding (e.g. when standing from the toilet)

• other urinary history

• dysuria, haematuria, previous urinary tract infections

• suprapubic pain

• coital incontinence

• other history

• constipation

• caffeine intake

• symptoms of prolapse: needing to reduce the prolapse to void

• previous gynaecological/urological procedures

Related

Examination Obstetrics _ Gynaecology