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

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

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

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

10. 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