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PubMed1984

Clinical judgment in the diagnosis and management of frequency and dysuria in general practice.

In a study of 40 women with the urethral syndrome and 46 women with conventional urinary tract infection, none of whom was pregnant, general practitioners predicted the diagnosis correctly before the report on the midstream urine specimen was received, as evidenced by their management. They seemed to do this by balancing the symptom of dysuria with the psychological make up of the patient: patients with the urethral syndrome suffered appreciably less dysuria than patients with urinary tract infection; patients with the urethral syndrome suffered appreciably more psychological illness. This ability to distinguish between the two disorders has important clinical and economic implications.

Diagnosis, Differential↗
PubMed1993

Long-term outcome of acupuncture in women with frequency, urgency and dysuria.

Urodynamic measurements including cystometry, anal sphincter electromyography, urethral pressure profilometry and uroflowmetry were carried out on 21 female patients before acupuncture and at 1 and 3 years during follow-up. Follow-up ranged from 60 to 72 months (average 66.2 months). There was no significant difference in all urodynamic measurements before acupuncture and at the 1 year or 3 years follow-up. During follow-up, acupuncture at the Sp-6 point was performed in patients who had recurrence of symptoms of frequency, urgency and dysuria. The number of acupuncture treatments ranged from 2 to 8 times, with an average number of 4.8 times. A decrease of acupuncture treatments after 30 months was noted on 8 patients, but it was not statistically significant. We concluded that the long-term outcome of acupuncture at the Sp-6 point for women with frequency, urgency and dysuria was positive, but that the effect was temporary and repeated acupuncture was necessary to maintain beneficial effects.

Acupuncture Points↗
PubMed1992

Urethral stones: US for identification in boys with hematuria and dysuria.

There are multiple causes for hematuria in infants and children. When hematuria is accompanied by dysuria, however, one should focus attention on the lower urinary tract. Although ultrasound (US) is a well-established method for assessing the kidneys and bladder, little attention has been focused on its use for evaluating urethral abnormalities, since voiding cystourethrography or retrograde urethrography usually is used. In the cases of two young boys, sonography aided in the identification of clinically unsuspected urethral stones. US evaluation of the urethra is now included as an integral part of urinary tract sonography in male patients with hematuria accompanied by dysuria.

Child↗
PubMed1986

Urinalysis and urine culture in women with dysuria.

In caring for women with acute dysuria, clinicians traditionally have relied on clinical findings to distinguish between acute pyelonephritis and "cystitis"; they have ordered urinalysis and urine culture regularly for patients with suspected acute pyelonephritis and ordered these tests inconsistently for patients with suspected "cystitis." Recent evidence indicates that "cystitis" may actually be any of six different clinical conditions, each of which is managed differently; subclinical pyelonephritis, lower urinary tract bacterial infection, chlamydial urethritis, other forms of urethritis, vaginitis, or dysuria without any urinary tract or vaginal infection. The distinction between these entities is made primarily from clinical findings. Urinalysis is also of great value in symptomatic patients; the presence of pyuria (and possibly indirect quantitation of pyuria by the leukocyte esterase test) is a reliable indicator of treatable infection, and its absence indicates infection is not present. In contrast, urine culture is of clear value only in patients with acute pyelonephritis or subclinical pyelonephritis.

Bacteriological Techniques↗
PubMedDate not supplied

[Treatment of stable dysuria in women].

The authors analyse treatment results for 88 women suffering from stable dysuria (SD). 44 of them with diagnosis "proliferative cystitis" underwent TUR of the bladder mucosa. The rest were treated conventionally. Biopsy of the bladder was made in all the patients. It is shown that mechanisms of SD development lies in that developing metaplasia of the squamous epithelium prevents close contacts between the surface cells leading to urine penetration into the submucous layer. This provokes frequent and painful micturition. The area of the bladder triangle contains vaginal epithelium (embryological) which changes according to the menstrual phases. Dysuria is more pronounced in the premenstrual period, i.e. in the period of marked desquamation of the squamous epithelial. Desquamation of the surface layer of metaplastic squamous epithelium cells and its thinning ease urine diffusion via intercellular space to the nerves and muscles of the bladder detrusor, thus deteriorating clinical symptoms. Thus, pain in full bladder results from functional failure of metaplastic multilayer squamous epithelium. To eradicate SD in such a situation, TUR of the bladder is recommended.

Adult↗
PubMed1990

[A bulky mass non-Hodgkin's lymphoma with dysuria in the rectovesical space].

A case of non-Hodgkin's lymphoma is reported. A 71-year-old man presented with complaint of dysuria and urinary frequency. Rectal examination and CT scan revealed a bulky mass in the rectovesical space. Transperineal needle biopsy of the tumor revealed non-Hodgkin's lymphoma, large cell type, diffuse. The patient received combination chemotherapy of adriamycin, cyclophosphamide, vincristine, prednisolone and pepleomycin. After two days the tumor was marvelously reduced in size, and partial response (PR) by CT was achieved after two months. PR was sustained for two months with cyclophosphamide, vincristine and prednisolone. However, the tumor progressed gradually, and he died five months after the first treatment and two additional courses of chemotherapy. Autopsy showed a 1,700 g bulky mass in the rectovesical space. The mass was covered with peritoneum and had a fistula from rectum to central necrosis of the tumor. Nine cases of the non-Hodgkin's lymphoma with complaint of dysuria have been reported in Japan before our case, which seemed to arise from the submucosal tissue of anterior rectal wall, prostate or lymphatic tissue of rectovesical space.

Aged↗
PubMed1990

[A case of retroperitoneal Hodgkin's disease with dysuria].

A case of retroperitoneal Hodgkin's disease with dysuria is reported. A 56-year-old man visited our hospital with the complaints of dysuria and lower abdominal mass. On physical examination, an unmovable hard smooth mass of fist size was palpable in the lower abdomen and prostate was slightly swelling by rectal digital examination. Excretory urography demonstrated medial deviation of left lower ureter and bladder deformity. Retrograde urethrocystography showed deviation and compression of prostatic urethra. On CT, tumors were composed of several round masses, which surrounded the left common iliac artery on angiography. Surgical extirpation was carried out and histological examination revealed Hodgkin's disease. As postoperative treatment, chemotherapy with cyclophosphamide, adriamycin, vincristine and prednisolone was performed, and 30 months after the operation the patient was asymptomatic.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

Urachal remnant as a cause of pollakiuria and dysuria in a filly.

A urachal remnant, causing pollakiuria and dysuria, was diagnosed by rectal palpation of a urinary bladder adhesion and endoscopic visualization of a urinary bladder diverticulum. Surgical excision of the remnant resulted in relief of abnormal micturition, but the filly was euthanatized 9 months after surgery because of a chronic ventral midline incisional infection. Pollakiuria and dysuria associated with urachal abscessation occur most commonly in calves. This report documents the syndrome in a horse.

Animals↗
PubMed1994

[The post-adenomectomy dysuria-hematuria syndrome].

The dysuria syndrome consists of the persistence or accentuation following adenomectomy of the symptoms which caused the patient to seek the urologist's advice. It is frequent event whose causes are largely connected to physiopathological events which are also influenced by the developing role between the urologist and patients in view of prostate disease. The authors analyse the various causes of post-adenomectomy dysuria and emphasise the importance of a precise diagnosis and the correct indications for surgery for the prevention of this disease.

Hematuria↗
PubMed1996

[Painful micturition (dysuria, algiuria)].

Painful micturition is one of the most common symptoms of urological diseases. The term "dysuria" is descriptive for micturition which the patient perceives as unpleasant. Usually, dysuria is combined with other symptoms such as pollakisuria (increased frequency of micturition) and urge (non suppressible compulsion of micturition). The symptoms may arise acutely or progress slowly and are often strictly linked to the act of micturition. The patients frequently complain of a burning pain at the beginning or during micturition. Therefore the anamnesis may already give the first clue for localization of the disease. The most common cause of painful micturition is an inflammation of the lower urinary tract. However, tumours, obstructive conditions and other less common urologic diseases must also be considered Basic diagnostics with urine analysis and culture can easily be done by almost all general practitioners. In doubtful cases, however, a special urologic examination is mandatory.

Female↗
PubMed1998

The women with dysuria.

Bacterial cystitis is the most common bacterial infection occurring in women. Thirty percent of women will experience at least one episode of cystitis during their lifetime. About one third of patients presenting with symptoms of cystitis have upper urinary tract infection. A careful history to identify risk factors for subclinical pyelonephritis is important. Symptoms of chronic cystitis accompanied by sterile urine without pyuria may represent interstitial cystitis. Dysuria may also be the principal complaint of women with vaginitis (infectious, atrophic or chemical) or urethritis. A stepwise diagnostic approach, accompanied by inexpensive office laboratory testing, is usually sufficient to determine the cause of dysuria.

Bacterial Infections↗
PubMedDate not supplied

Chlamydia trachomatis associated with chronic dysuria among patients with Schistosoma haematobium.

Eighty-seven Egyptians with Schistosoma haematobium infection (current or past) and chronic dysuria seen at the Theodor Bilharz Research Institute outpatient urology clinic in Imbaba, Cairo, Egypt were investigated for Chlamydia trachomatis infection. Direct fluorescent antibody tests (DFAT) showed 30 urethral swabs (35%) and 40 urine sediments (46%) were positive for Chlamydia. Indirect fluorescent antibody testing showed 29 (34%) serum samples and 25 (29%) urethral smears were positive for Chlamydia. There was a highly significant association between patients with active Schistosoma infection and those with urine and urethral specimens positive for Chlamydia by DFAT (P < 0.01).

Adolescent↗
PubMed1981

Supra-vaginal uterine amputation vs. abdominal hysterectomy: the effects on urinary symptoms with special reference to pollakisuria, nocturia and dysuria.

Post-operative symptoms of hysterectomy have received relatively little attention in the literature. In the present study the first author has personally interviewed and examined 105 abdominal hysterectomy patients and 107 patients with supravaginal uterine amputation pre-operatively and thrice post-operatively. At one year the follow-up percentage was 99.5 (211/212). In the statistical analysis McNemar's test of symmetry and Fisher's exact test were used. Loglinear models were developed where applicable. A number of patients had urinary symptoms pre-operatively: 27.6% of the abdominal hysterectomy and 48.6% of the supra-vaginal amputation patients suffered from pollakisuria; preoperative nocturia and dysuria were present in about 10% of patients in each group. These urinary symptoms disappeared more frequently in patients who underwent supra-vaginal amputation; with regard to pollakisuria the difference is statistically significant. Twelve months post-operatively pollakisuria was present in 10.3% of supra-vaginal amputation and 13.5% of hysterectomy patients. The advantage of supra-vaginal amputation over abdominal hysterectomy with regard to these symptoms may result from the considerably less extensive manipulation of the bladder during supra-vaginal amputation. Possibly the support provided by the remaining stump and the round ligaments fixed to it also help to reduce urinary symptoms in these patients. However, further urodynamic studies are needed.

Adult↗
PubMed1996

Dysuria associated with urethral caruncle in the dog.

Three cases of urethral caruncle were recognized in bitches with a history of chronic dysuria. Clinical and radiological examinations revealed the presence of inoperable lesions involving much of the urethra in all three cases. At post-mortem examination of Case 1, an oval swelling, 1.5 x 1.0 cm, was detected within the wall of the urethra close to the vagino-urethral orifice. In Case 2, firm, mottled yellow, white and red tissue formed a thickening between the urethra and vagina. In Case 3, a cylindrical cream mass, 8 cm long and 3 cm in diameter, surrounded the urethra and impinged on the wall of the vagina. Histologically, glandular structures lined by a single layer of epithelial cells and a mixed granulomatous inflammatory reaction were present in the wall of the urethra of all three cases.

Animals↗
PubMed1983

Lacuna magna: a hidden cause of dysuria and bloody spotting in boys.

Intermittent hematuria, dysuria, or bloody spotting of underwear are symptoms occasionally seen in young boys. The lacuna magna (valve of Guerin) is a common embryologic remnant often found to be the cause of these symptoms. While retrograde urethrography may occasionally be helpful, voiding films that include the distal penile urethra usually establish the diagnosis. Transmeatal excision or incision of the valve-like leaflet is curative, but often the problem is benign and self-limiting even without treatment.

Child↗
PubMed1994

Lacuna magna in 6 boys with post-void bleeding and dysuria: alternative approach to treatment.

Six boys from 8 to 17 years old presented with blood dripping from the meatus at the termination of urination, spotting of blood on underwear and/or distal penile dysuria. Repeat urinalyses and cultures were negative, and evaluation included a voiding cystourethrogram. Diagnosis was lacuna magna in the area of the fossa navicularis, which was confirmed by cystoscopy. Each patient was treated endoscopically using a pediatric resectoscope and right-angle wire electrode. The value was incised with the cutting current and the base of the diverticulum was fulgurated. We find that this method of treatment is preferable to incision with tenotomy scissors.

Adolescent↗
PubMed1984

Methamphetamine abuse presenting as dysuria following urethral insertion of tablets.

Foreign bodies are inserted into the male urogenital tract for a variety of motives, and patients may present with symptoms of dysuria, urinary retention, hematuria, discharge, or priapism. Concomitant psychopathology is seen frequently, necessitating a thorough psychiatric assessment with attention to other acts of self-mutilation, suicide attempts, psychosis, or substance abuse. We report the case of an abuser of methamphetamine who inserted a sustained-release form of medication into his urethra, with resulting mechanical and pharmacological trauma.

Adult↗