Genitourinary system

BY Dr Adam A
SYMPTOMS OF GENITOURINARY DISEASES

• Renal pain: This is pain arising from the

kidneys and
• is usually felt at or below the costal margin
posteriorly
• may radiate anteriorly towards the umbilicus.
is typically dull aching and steady
• Ureteric pain: Results from sudden distention
of the ureter and associated distentention of
renal pelvis.
• It is severe colicky pain which originates in the
costovertebral angle.
• It may radiate into the lower quadrant of the
abdomen and possibly to the upper thigh and
testicle or labium
• Hematuria: Is the presence of red blood cells
in the urine.
• Oliguria: Denotes the passage of less than 400
ml of urine per day.
• Anuria: Is the complete absence of urine
output.
• Retention of urine should be excluded before
a patient is considered to have anuria.
• Polyuria: Implies a high urine output.
It is an arbitrary definition, on the basis of 24
Hours urine output of more than 3L per day.
Urinary frequency: Is an abnormally frequent
voiding. It results from polyuria or from a
decrease in the functional bladder capacity as in
bladder irritation or inflammation.
 Nocturia : Implies the need to rise during hours of
sleep to empty the bladder.
• Dysuria: Is a specific form of discomfort arising from
the urinary tract in which there is
• pain immediately before, during or immediately after
micturation.
• Urgency: Is the loss of the normal ability to postpone
micturation beyond the time when the desire to pass
urine is initially perceived.
• Incontinence: Refers to an involuntary loss of
urine that has become a social or hygienic
problem.
• Hesitancy: Is difficulty initiating the process of
micturation.
• Terminal dribbling: is difficulty of completing
micturation in a clean stop fashion.
• Urethral discharge: is nearly always a
complaint of men, in the form of;
o dripping
o staining of the underwear
• Genital ulcer: This may be recurrent, single or
multiple, painful or painless.
• It is important to ascertain the evolution of
the ulcer.
• Common causes include;
o chancre of primary syphilis
o chancroid
o genital herpes
• Vaginal discharge
• can be associated with itching
• the color, odor and amount should be
characterized.
 Physical examination
• Male genitalia;
Inspection;
Skin; for excoriations or inflamation.
Prepuce ; for phimosis.
Glans ; for ulcer ,scar, nodule or sign of inflation.
Urethral meatus; for location of urethral meatus.
Eg . hypospadias = congenital ventral displacement of u.
meatus.
Milk the urethra see for discharge. Yellow or white.
 Cont…
• Palpation;
• Palpate shaft of genitalia bn thump and firt
two fingers, notes for induration and
tenderness. Eg u stricture.
• Scrotum exam
• Inspection;
• Skin, for scar, lesion or pubic hair distribution.
• Scrotum for swelling or mass.
• Inguinal area for erythema or adenopathy.
• Palpation
• Palpate each testes and epididymis bn thump
firs two fingers.
• Tenderness, eg epididymitis, orchitis, torsion
of spermatic cord.
• Asses testes for size, consistency, shape and
tenderness. Asses for mass or nodule.
• Female genitalia.
External genitalia examination;
Asses sexual maturity of adolescent, pubic hair chrx and
distribution.
Inspect the monspubis, labia, prenium.
Separate the labia and insoect;
labia minora
clitoris
urethral meatus
vaginal opening and introitus.
• Note any inflammations, ulceration, discharge,
swelling or nodule. Palpate any lesions.
Examine Bartholin glands. If any labial swelling.
• Internal examination
• Speculum examination; select appropriate size
and shape , moisten with warm water and
insert speculum.
• inspect the cervix; note the color of cx,
position and surface chrx. Any ulcer, nodule,
mass, bleeding or discharge,
• obtain spacemen for cervical cytology(pap
smear).
• perform a Bimanual examination
• Lubricate your index finger and middle finger
of one of your gloved hand from standing
position, insert your lubricated finger in to the
vagina ,again exerting pressure primarily
posteriorly. Note for any nodularity or
tenderness in the vaginal wall, region of
urethra and urinary bladder anteriorly.
• Palpate cx ; noting its position, consistency,
regularity, mobility and tenderness. Eg PID,
Ectopic pregnancy and appendicitis.
• Palpate ux ; note its size, consistency, shape,
mobility, tenderness or mass. Eg ux
enlargement; preg, myomas or malignancy.
THANK YOU