Genitourinary disorders Symptoms and Causes

diagnosis

Interstitial cystitis: A potassium sensitivity test is the standard diagnostic for interstitial cystitis. During the procedure, a flexible tube, called a catheter, is used to fill the bladder is with distilled water. Then, the bladder is filled with a potassium solution. After each solution is instilled into the bladder, the patient rates how much pain and urgency to urinate they feel. If the patient feels more pain or urgency to urinate with the potassium solution than with the water, the patient is diagnosed with interstitial cystitis. Although researchers are unsure whether the potassium solution indicates increased bladder permeability or hypersensitive sensory nerves, patients with interstitial cystitis have been shown to be sensitive to the solution. Healthy patients do not notice any different between the two solutions.
Kidney stones (renal culculi): Imaging studies, such as a computerized tomography (CT) scan or magnetic resonance imaging (MRI) scan may be performed if kidney stones are suspected. These tests take pictures of the kidneys, allowing healthcare providers to detect kidney stones.
Neurogenic bladder: If it is suspected that the patient has a neurogenic bladder, tests are performed to evaluate the bladder and nervous system.
Tests may be performed to determine how much water the bladder can hold and whether it is able to empty completely and efficiently.
Imaging studies, including X-rays, CT scans, and MRI scans, may be performed to take pictures of the urinary tract and nervous system. The images may show abnormalities that indicate nerve damage.
A healthcare provider may perform a test called an electroencephalograph (EEG) to detect abnormalities in the brain that may be causing the condition. During the procedure, small electrodes are taped to the patient's forehead. The electrical signals from the brain are transmitted to a small monitor. If the signals are abnormal, a positive diagnosis is made.
An electromyography (EMG) may also be performed to test the muscles and nerves of the bladder. During the procedure, a needle electrode is inserted through the skin and into the bladder muscle. The electrical activity detected by the electrode is displayed on a screen.
Pelvic inflammatory disease (PID): Pelvic inflammatory disease (PID) is diagnosed after a pelvic examination, cervical cultures, and/or analysis of the vaginal discharge. During a pelvic exam, a small instrument called a speculum is inserted into the vagina and the healthcare provider is able to examine the vagina, cervix, and uterus. The reproductive organs, including the uterus, will appear inflamed during a pelvic exam. Cervical cultures and/or analyses of vaginal discharge are performed to detect the presence of bacteria that are known to cause PID. If bacteria are present, a positive diagnosis is made.
Prolapsed uterus: A prolapsed uterus is diagnosed after a pelvic exam. Imaging studies, such as CT scans or MRI scans, are often needed to determine the severity of the condition.
Urinary incontinence: Patients who experience urinary incontinence should visit their healthcare providers to determine the underlying cause. Since it is common for children younger than seven years old to wet the bed, they usually do not require a medical diagnosis. Several tests may be performed to diagnose the patient. A healthcare provider may ask the patient to record fluid intake, time of urination, and number of incontinence episodes over the course of several days.
A sample of urine may be collected from the patient to check for an infection.
A sample of blood may be taken from the patient to check for medications or chemicals that may be causing incontinence.
A postvoid residual (PVR) measurement test may be performed to determine if the patient is able to empty the bladder. Patients urinate into a container that allows the healthcare provider to measure the amount of urine that is excreted. Then, the healthcare provider inserts a soft, thin tube into the urethra and bladder to drain any remaining urine. If there is a lot of urine left in the bladder, this may indicate that there is an obstruction (such as at tumor) or a problem with the muscles or nerves.
A pelvic ultrasound may be performed to detect abnormalities in the urinary tract. During a pelvic ultrasound in females, a probe, called a transducer, is inserted into the vagina. The transducer sends pictures of the pelvic organs to a nearby camera. During a pelvic ultrasound in males, a transducer is inserted into the rectum, and pictures are taken of the pelvic organs, including the prostate and seminal vesicles.
Urodynamic testing may also be performed to measure the pressure inside the bladder when it is empty and when it is filling. A catheter is inserted through the patient's urethra and into the bladder. The bladder is then filled with water. The pressure inside the bladder is monitored. This test allows the healthcare provider to measure the strength of the bladder muscle.
A cystoscopy may be performed to detect possible abnormalities in the urinary tract. During the procedure, a thin tube with a camera, called a cystoscope, is inserted into the urethra and into the urinary tract. The cystoscope projects images of the urinary tract onto a screen.
Urinary tract infection: A urine analysis is the standard diagnostic test for a urinary tract infection. A sample of the patient's urine is analyzed in a laboratory. If disease-causing microorganisms are present, a positive diagnosis is made. Puss and blood cells may also be detected in the urine, which suggest an infection.

signs and symptoms

Interstitial cystitis: Symptoms of interstitial cystitis vary among patients. Individual patients may also experience changes in the severity of symptoms over time. For instance, stress, menstruation, allergies, and sexual activity may worsen symptoms.
Common symptoms include a frequent urge to urinate and passing small amounts of urine many times a day. Patients with severe interstitial cystitis may urinate more than 50 times in one day. Patients may experience pain in the pelvis or perineum (area between the anus and genital organs). Some patients may experience pain during sexual intercourse. Males may also experience pain when they ejaculate.
Some patients may experience either pain or frequent urination. However, most patients experience a combination of both symptoms.
Kidney stones (renal calculi): If the kidney stone is small, patients do not experience any symptoms of the condition. However, if the stone is large enough to block the tubes inside the kidney, patients may experience an intense pain that often comes and goes. Pain may last anywhere from five to 15 minutes at a time. The pain usually begins in the lower back. As the stone moves from the kidney toward the bladder, the patients may feel pain near the abdomen, groin, or genitals. Additional symptoms may include blood in the urine, cloudy or foul-smelling urine, nausea, vomiting, and constant urge to urinate.
In some patients, the kidney stone may cause an infection. Symptoms of an infection include fever and chills.
Neurogenic bladder: Damaged or defective nerves may send signals to the bladder at the wrong time, causing the muscles to spontaneously contract. This causes the bladder to become overactive. Symptoms of an overactive bladder may include frequent urination, persistent urge to urinate, and spontaneous emptying of the bladder that cannot be controlled (incontinence). Urine may occasionally leak out in small amounts throughout the day.
Other patients with neurogenic bladders may have underactive bladders. This happens when the nerves do not receive the message that the bladder is full or the message is too weak for the bladder to be completely emptied. When the nerves do not function properly, urine builds up in the bladder (urine retention). An overfull bladder may empty without warning. If the bladder is too full, it may back up and put pressure on the kidneys. Urine retention may also lead to an infection of the bladder or kidney.
Pelvic inflammatory disease (PID): Common symptoms of pelvic inflammatory disease (PID) include pain in the lower abdomen and pelvis, irregular menstrual bleeding, foul-smelling vaginal discharge, lower back pain, fever, fatigue, diarrhea, vomiting, pain during intercourse, and difficulty or pain during urination.
Prolapsed uterus: Symptoms of a prolapsed uterus vary depending on the severity of the condition. Mild cases may not cause any symptoms. Common symptoms may include a feeling of fullness or pressure in the pelvis, lower back pain, sensation that something is falling out of the vagina, difficulty urinating or moving the bowels, and difficulty walking.
Urinary incontinence: Patients with urinary incontinence are unable to control their bladders. Urine may leak out when the patient laughs, coughs, exercises, or lifts heavy weights. Small amounts of urine may leak out periodically throughout the day or night. Some patients may experience a sudden urge to urinate followed by an uncontrolled emptying of the bladder. Some patients may be unable to empty their bladders completely. As a result, urine may build up in the bladder until it cannot hold any more fluid. When this happens, the bladder spontaneously releases the urine. Some patients, especially children younger than seven years old, may be unable to control their bladders during sleep.
Urinary tract infection (UTI): Common symptoms of a urinary tract infection (UTI) include a constant urge to urinate, burning sensation during urination, blood in the urine (hematuria), cloudy or foul-smelling urine, and frequently passing small amounts of urine.
If the bladder becomes inflamed the condition is called cystitis. Symptoms of cystitis may include pelvic pressure, pain in the lower abdomen, and painful and frequent urination.
If the urethra becomes inflamed (urethritis), patients may experience a burning sensation during urination. Men with urethritis may experience penile discharge.
If the epididymis becomes inflamed in males, symptoms may include scrotal pain, tenderness in one or both testicles, tenderness in the groin, painful urination, painful intercourse or ejaculation, blood in the semen, and swelling of one or both testicles (orchitis).

complications

Infertility: Patients with pelvic inflammatory disease (PID) may become infertile. Patients who wait to receive treatment have the greatest risk of becoming infertile. Therefore, patients who experience signs and symptoms of PID should visit their healthcare providers as soon as possible.
Pain: Up to 50% of females with PID develop chronic pelvic pain that may last for months or years. PID may cause scarring in the fallopian tubes and other organs that may lead to pain during exercise, ovulation, and sexual intercourse.
Patients with interstitial cystitis may experience severe pain. This pain may worsen during sexual intercourse or ejaculation. This may affect sexual intimacy among couples. Medications are available to reduce these symptoms. Patients should regularly visit their healthcare providers to ensure that their treatments are effective.
Skin problems: Patients with urinary incontinency may develop skin rashes, infections, or sores.
Quality of life: Patients who experience urinary incontinence may also suffer from a decreased quality of life. Patients may be less likely to travel or participate in activities because they are worried about having accidents. Patients with incontinence should visit their healthcare providers to diagnose and treat the underlying cause.