DIAG 2735 Detailed UA Definitions

DIAG 2735 Detailed UA Definitions - URINARY URGENCY A...

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URINARY URGENCY A sudden compelling urge to urinate, accompanied by bladder pain, is a classic symptom of urinary tract infection. As inflammation decreases bladder capacity, discomfort results from the accumulation of even small amounts of urine. Repeated, frequent voiding in an effort to alleviate this discomfort produces urine output of only a few milliliters at each voiding. Urgency without bladder pain may point to an upper motor neuron lesion that has disrupted bladder control. Assessment Ask the patient about the onset of urinary urgency and whether he's ever experienced it before. Ask about other urologic symptoms, such as dysuria and cloudy urine. Also ask about neurologic symptoms, such as paresthesias. Examine his medical history for recurrent or chronic urinary tract infections or for surgery or procedures involving the urinary tract. Obtain a clean-catch sample for urinalysis. Note urine character, color, and odor, and use a reagent strip to test for pH, glucose, and blood. Then palpate the suprapubic area and both flanks for tenderness. If the patient's history or symptoms suggest neurologic dysfunction, perform a neurologic examination. Possible causes Amyotrophic lateral sclerosis (ALS): ALS occasionally produces urinary urgency. More common findings include muscle weakness, cramping, atrophy, and coarse fasciculations in the forearms and hands. Brain stem involvement produces speech, chewing, swallowing, and breathing difficulty. Bladder calculus: Bladder irritation can lead to urinary urgency and frequency, dysuria, hematuria, and suprapubic pain from bladder spasms. Multiple sclerosis (MS): Urinary urgency can occur with or without the frequent urinary tract infections that often accompany MS. Like MS's other variable effects, urinary urgency may wax and wane. Commonly, visual and sensory impairments are the earliest findings. Others include urinary frequency, incontinence, constipation, muscle weakness, paralysis, spasticity, intention tremor, hyperreflexia, ataxic gait, dysphagia, dysarthria, impotence, and emotional lability. Reiter's syndrome: In this self-limiting syndrome that primarily affects males, urgency occurs with other symptoms of acute urethritis 1 to 2 weeks after sexual contact. Arthritic and ocular symptoms and skin lesions usually develop within several weeks. Spinal cord lesion: Urinary urgency can result from incomplete cord transection when voluntary control of sphincter function weakens. Urinary frequency, difficulty initiating and inhibiting a urinary stream, and bladder distention and discomfort may also occur. Neuromuscular effects distal to the lesion may include weakness, paralysis, hyperreflexia, sensory disturbances, and impotence. Urethral stricture:
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This note was uploaded on 11/23/2011 for the course DIAG 2735 taught by Professor Josephr.forese during the Winter '11 term at Life Chiropractic College West.

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DIAG 2735 Detailed UA Definitions - URINARY URGENCY A...

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