How to diagnose Urologic Disorders

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Presentation transcript:

How to diagnose Urologic Disorders dr. Arnold Simandjuntak,Sp.U.

History Taking Age Work at..... Retired from..... - tire - plastic - - carcinogenic material - tar Women : - marital status :-how long -number of children -age of children - labor status : -catherization -forceps -penneal fear Catamenia : -menarche -climacterium -menopause

Chief Complain : something that makes a patient goes to doctor For example: Pain Fever Mass Bloody urine Hesitancy Weak urinary stream Incontinence Urethral discharge Smoking (too much) Infertility Physical weakness Frequency Trauma Dysuria Dribbling Enuresis Flank discomfort Congenital anomalies Sexual dysfunction Urine retention

Previous disease and history of family illness: Veneral disease Diabetes Tubercolose Bouginage Urogenital trauma Surgery Menstrual Cycle (women) Tropical / hot climate country (stone disease) Imported disease (Schistosomiasis) B. Urologic physical examinations B. Urologic physical examinations B. Urologic physical examinations B. Urologic physical examinations

B. Urologic physical examinations General condition : a. Don’t be hurry b. Check every system & organ systematically (not only urogenital organ) c. Observe the patient when he/she comes to the examination room: - normal walk - assisted - on wheel chair - crooked d. Exam : - vital sign - wasting/reduction of body weight - tension, depression, pale, painful Abdominal examination : Liver & Spleen Kidney Suprapubic area Groin/Inguinal area External Genital Organ : Men : Penis & Scrotum Women : Vulvus & Urethra

4. Digital Rectal Examination (DRE) - Perianal Region - Sphinter ani tones - Rectal ampoule - Surface of the mucosal rectum - Prostate (male): - symetric - upper part - consistency - nodule - pain - gloves - Reflex bulbocavernosus

C. Laboratory examinations URINE : - How to catch urine - Macroscopic examination - Color & appereance - Chemical test: - pH - protein - glucose - hemoglobine - bacterial & leucocyte - Microscopic urinalysis: - staining - erythrocytes - leucocytes - casts - epithelial cell - culture & resistency test - Cytology of the urine

BLOOD : - Kidney function : Ureum, Creatinine - Tumor marker : BTA, PSA

D. Imaging X ray : KUB, IVP, RPG, APG USG USG Doppler CT Scan MRI PET Scan Arteriography (not anymore)

Conclusion The same procedure with the other disease to find a diagnosis of the urologic disorder. Consist of : History, Physical exam, Lab, Imaging Always in our mind : 60-70% diagnosis is based on history The sophisticated equipment is only a compliment

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