Urinary DDx

Question 1

What is dysuria?

Answer 1

Dysuria means painful urination.
Frequency means needing to pass urine frequently.

Consider:
* Urinary tract infection (cystitis, urethritis)
* Prostatic disease
* Urinary tract stones
* Bladder tumours
* Pelvic Floor Dysfunction

Question 2

What is Haematuria?

Answer 2

Haematuria means blood in the urine.

Consider:

Prostatic disease
Urethral trauma

Bladder disease:
Tumours
Stones
Trauma

Kidney disease:
Glomerulonephritis
Polycystic disease
Kidney stones
Carcinoma
Analgesic nephropathy
Acute pyelonephritis
Trauma

Bleeding disorders such as sickle cell disease and bacterial endocarditis may occasionally present as haematuria

Question 3

What is Polyuria?

Answer 3

Polyuria means the passing of copious amounts of urine.

Consider:

Increased fluid intake
Diuretics
Diabetes mellitus
Diabetes insipidus
Renal failure
Hypercalcaemia

Question 4

What is abnormal urine?

Answer 4

Abnormal urine
Urine has a wide range of normal colours and consistencies:

• Milky yellow urine may be due to pus in the urine from an infection
• Dark yellow urine can be caused by dehydration
• Dark brown urine (like tea without milk) may be a sign of liver disease
• Red blood in the urine may be a sign of infection, cancer, kidney stone, or other kidney disease

Question 5

Also consider…what?

Answer 5

Testicular Mass (lump)
Consider:
Painless: testicular cancer
Painful: may be secondary to a sexually transmitted disease

Infrequent urination
Consider:
Kidney failure
Dehydration
Pelvic Floor Dysfunction

Abnormal urine flow
In the context of weak urinary stream, straining to begin urination, or a tendency to stop/start mid-urination, consider:
Pelvic Floor Dysfunction
Enlarged Prostate

Incontinence
Incontinence may be caused by a variety of conditions, broadly divided into 5 categories:

Nerve related e.g., Multiple sclerosis, spinal cord damage as the result of trauma, spinal epidural abscess or spinal cord neoplasm
Prostate related e.g., prostatitis
Infection/inflammation e.g., urinary tract infection, vaginitis
Obstruction
Pelvic Floor Dysfunction