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Dysuria in Children

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121. Clinical Practice Guidelines on Prevention, Diagnosis and Management of Tuberculosis

laboratory diagnosis 41 7 Treatment of tuberculosis 48 8 Public health screening and infection control 70 9 Tuberculosis contact investigations and screening 78 10 Tuberculosis in children - specific considerations 85 11 Cost-effectiveness issues 89 12 Clinical quality improvement 90 Appendix 1 Recommendations for sputum collection 91 Annex 1 MD 532 Notification of Tuberculosis 93 Annex 2 MD 117 Treatment Progress Report 95 References 97 Self-assessment (MCQs) 112 Workgroup members 114 ContentsD Foreword (...) to the Tuberculosis Control Unit or specialists with experience in tuberculosis management. GPP 262 No. Recommendation Grade, Level of evidence CPG Page No. 6 Two sputum samples – including one early morning sample – should be obtained for both microscopy and mycobacterial cultures for patients with suspected pulmonary tuberculosis. Recommendations for sputum collection are in Appendix 1 (page 91). Grade D Level 4 27 7 In patients in whom it is difficult to obtain sputum specimens, e.g. children and stroke

2016 Ministry of Health, Singapore

122. Male Urethral Stricture

statements of Strong, Moderate, or Conditional Recommendation based on risks and benefits were developed. Additional information is provided as Clinical Principles and Expert Opinions when insufficient evidence existed. Guideline Statements Diagnosis/Initial Management 1. Clinicians should include urethral stricture in the differential diagnosis of men who present with decreased urinary stream, incomplete emptying, dysuria, urinary tract infection (UTI), and after rising post void residual. (Moderate (...) tend to be located in the bulbar and posterior urethra. Preoperative Assessment Presentation Patients with urethral stricture most commonly present with decreased urinary stream and incomplete bladder emptying but may also demonstrate UTI, epididymitis, rising post-void residual urine volume or decreased force of ejaculation. Additionally, patients may present with urinary spraying or dysuria. 10 Patient Reported Outcomes Measures Patient reported measures (PRMs) help elucidate the presence

2016 American Urological Association

124. Surgical Management of Stones: AUA/Endourology Society Guideline

(s). Index Patients 13 and 14 are children (<18 years if age) with similar characteristics to Index Patients 1-10. Index Patient 15 is a pregnant female with symptomatic renal or ureteral stone(s) with normal renal function without urinary tract infection (UTI). The proximal ureter is defined as the segment distal to the ureteropelvic junction (UPJ) and above the upper border of the sacroiliac joint. The middle ureter is that which overlies the sacroiliac joint and the distal ureter that lies (...) number of studies were available to provide comparative effectiveness inferences in children. Imaging, Pre-operative Testing Guideline Statement 1 Clinicians should obtain a non-contrast CT scan on patients prior to performing PCNL. Strong Recommendation; Evidence Level Grade C × Discussion Neither randomized trials nor comparative studies have specifically addressed the role of preoperative CT prior to PCNL. Nevertheless, the use of CT for preoperative assessment in those with nephrolithiasis has

2016 American Urological Association

126. Urinary Tract Infection?Child

, and the second peak of UTI occurs between the ages of 2 to 4 years during toilet training. After the age of 6 years, UTIs are infrequent and often associated with dysfunctional elimination [8]. Cystitis is a UTI limited to the bladder. Cystitis typically presents with localizing symptoms of frequency, urgency, and dysuria. Acute pyelonephritis is infection of the kidneys. Pyelonephritis typically presents with systemic symptoms such as high fever, malaise, vomiting, abdominal or flank pain, and tenderness [3 (...) -6]. Pyelonephritis can cause renal scarring, which is the most severe long-term sequela of UTI and can lead to hypertension and chronic renal failure [3-6]. With the increased use of prenatal ultrasound (US), it was realized that many of the scars that were attributed to pyelonephritis actually occur in utero and represent renal dysplasia [3-6]. Contrary to earlier studies suggesting that renal scarring secondary to pyelonephritis is the most common cause of chronic renal disease in children

2016 American College of Radiology

127. Management of Chronic Pain in Survivors of Adult Cancers

Dyspareunia, vaginal pain Dysuria Eye pain Oral pain and reduced jaw motion Paresthesias Scleroderma-like skin changes Surgical pain syndromes Lymphedema Postamputation phantom pain Postmastectomy pain Postradical neck dissection pain Postsurgery pelvic floor pain Post-thoractomy pain/frozen shoulder Postsurgery extremity pain (eg, sarcoma) Recommendation 1.4. Clinicians should evaluate and monitor for recurrent disease, second malignancy, or late-onset treatment effects in any patient who reports new

2016 American Society of Clinical Oncology Guidelines

128. Diagnosis of Right Lower Quadrant Pain and Suspected Acute Appendicitis

, Canada Tyler Hughes, M.D. McPherson Hospital McPherson, KS Douglas Katz, M.D., FACR Vice Chairman of Research and Education Winthrop Radiology Associates Winthrop-University Hospital, Department of Radiology Director of Body CT, Winthrop-University Hospital Mineola, NY Anupam Kharbanda, M.D., M.Sc. Director of Research, Emergency Services Associate PEM Fellowship Director Department of Pediatric Emergency Medicine Children’s Hospitals and Clinics of Minnesota Minneapolis, MN Susan Promes, M.D (...) , KS Douglas Katz, M.D., FACR Vice Chairman of Research and Education Winthrop Radiology Associates Winthrop-University Hospital, Department of Radiology Director of Body CT, Winthrop-University Hospital Mineola, NY Anupam Kharbanda, M.D., M.Sc. Director of Research, Emergency Services Associate PEM Fellowship Director Department of Pediatric Emergency Medicine Children’s Hospitals and Clinics of Minnesota Minneapolis, MN Susan Promes, M.D. University of California San Francisco School of Medicine

2016 Effective Health Care Program (AHRQ)

129. WHO guidelines for the treatment of Genital Herpes Simplex Virus

HSV herpes simplex virus HSV-1 herpes simplex virus type 1 HSV-2 herpes simplex virus type 2 MSH Management Sciences for Health MSM men who have sex with men NAAT nucleic acid amplification test PICO population, intervention, comparator, outcome POCT point-of-care diagnostic test STI sexually transmitted infection UNAIDS Joint United Nations Programme on HIV/AIDS UNDP United Nations Development Programme UNFPA United Nations Population Fund UNICEF United Nations Children’s Fund WHO World Health (...) and reproductive health services that are needed to attain the related targets under Sustainable Development Goal (SDG) No. 3 (Ensure healthy lives and promote well-being for all at all ages), including: target 3.2 – to end preventable deaths of newborns and children under 5 years of age; target 3.3 – to end the epidemics of AIDS and other communicable diseases; target 3.4 – to reduce premature mortality from noncommunicable diseases and promote mental health and well-being; target 3.7 – to ensure universal

2016 World Health Organisation Guidelines

130. WHO guidelines for the treatment of Chlamydia trachomatis

FOR THE TREATMENT OF CHLAMYDIA TRACHOMATIS STI Guideline Development Group (GDG): Chairpersons: Judith Wasserheit, Holger Schünemann and Patricia Garcia Members: * 8 ' @W K D WD ? H F W VO \ P S K R L G W L VVX H D Q GW U D F K R P D H \ HL Q I H F W L R Q CLINICAL PRESENTATION Genital infections due to C. trachomatis are DV \ P SW R P DW L FL QD S S U R [ L P DWH O \ RIZR P H QD Q G RIP H Q (2). Symptoms of uncomplicated chlamydial infection in women include abnormal vaginal discharge, dysuria, and post (...) -coital and intermenstrual bleeding. Common clinical signs on speculum examination include cervical friability and discharge. Symptomatic men usually present with urethral discharge and dysuria, sometimes accompanied by testicular pain. If left untreated, most genital infections will resolve spontaneously with no sequelae but they may result in severe complications, mainly in young women. Infection can ascend to the upper reproductive tract and can F D X V HS H O Y L FL Q A D P P D W R U \G LVH D VHH

2016 World Health Organisation Guidelines

131. WHO guidelines for the treatment of Neisseria gonorrhoeae

Training in Human Reproduction HSV-2 herpes simplex virus type 2 IM intramuscular MSH Management Sciences for Health MSM men who have sex with men NAATs nucleic acid amplification tests PICO population, intervention, comparator, outcome POCT point-of-care test STI sexually transmitted infection UNAIDS Joint United Nations Programme on HIV/AIDS UNFPA United Nations Population Fund UNICEF United Nations Children’s Fund WHO World Health Organization1 WHO GUIDELINES FOR THE TREATMENT OF NEISSERIA (...) lives and promote well-being for all at all ages), including: target 3.2 – to end preventable deaths of newborns and children under 5 years of age; target 3.3 – to end the epidemics of AIDS and other communicable diseases; target 3.4 – to reduce premature mortality from noncommunicable diseases and promote mental health and well-being; target 3.7 – to ensure universal access to sexual and reproductive health-care services; and target 3.8 – to achieve universal health coverage. Worldwide, more than

2016 World Health Organisation Guidelines

132. GreenLight XPS for treating benign prostatic hyperplasia

Prostate Symptom Score [IPSS] and International Prostate Symptom Score Quality of Life [IPSS- QOL], change in prostate volume, maximum flow rate [Qmax], post-void residual volume [PVR]) duration of catheterisation rate of dysuria (pain) quality of life length of hospital stay frequency of completion as a day-case rate of re-admission procedural blood loss and blood transfusion need rate of transurethral resection of the prostate (TURP) syndrome rate of capsular perforation device-related adverse events (...) and Healthcare Products Regulatory Agency Professor Janelle Y Professor Janelle Y ork orke e Lecturer and Researcher in Nursing, University of Manchester Dr Amber Y Dr Amber Y oung oung Consultant Paediatric Anaesthetist, Bristol Royal Hospital for Children GreenLight XPS for treating benign prostatic hyperplasia (MTG29) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 26 of 30NICE lead team Each medical technology assessment

2016 National Institute for Health and Clinical Excellence - Medical technologies

133. New Zealand Guideline for the Management of Gonorrhoea

Partner notification 39 Management of sexual partners/contacts 39 Management of gonorrhoea in children 40 Testing for N. gonorrhoeae in prepubertal children 40 When should N. gonorrhoeae testing be undertaken in prepubertal children? 41 Which specimens should be taken, and which tests should be requested? 41 Additional testing 42 Gonorrhoea typing 42 NAAT 42 Management of gonorrhoea in prepubertal children (excluding neonates) 42 For uncomplicated anogenital and pharyngeal gonorrhoea (not in neonates (...) . For more detailed discussion, see ‘Laboratory testing for N. gonorrhoeae’, page 21, and the following text. Version 2014-09-1 0 28 New Zealand Guideline for the Management of Gonorrhoea The following should be noted: ? The recommendations in this section apply to male, female, and sex- and gender-minority adults postpuberty in New Zealand. ? For prepubertal sampling, see ‘Management of gonorrhoea in children’, page 40. ? For testing of adults where recent sexual assault is a consideration, please

2014 New Zealand Sexual Health Society

134. Ureteric stent

perform a hand wash and dry hands thoroughly record the procedure and volume of urine in the child’s health records ( ) The child and family must be reminded that pain may be experienced as the kidney pelvis fills up and during the first micturition. The child’s first micturition must be documented on the fluid balance chart and in the child’s health care record ( ). The child's doctor must be informed if the child: is unable to pass urine ( ) has dysuria or loin pain if the entry site leaks (...) on their first micturition ( pressure should be applied) ( ) The dressing should be removed after 24 hours ( ). O nce the site is healed a dressing will no longer be required. Discharge The child’s parents should be advised to contact the ward if, once discharged, they have concerns about the wound site ( ). The family must be told to contact the ward if the child experiences any of the following problems: if the child is unable to pass urine ( ) the child has dysuria or loin pain ( ) Rationale Rationale 1

2014 Publication 1593

135. Paediatric Urology

Epidemiology, aetiology and pathophysiology 12 3C.2 Diagnostic evaluation 12 3C.3 Disease management 12 3C.4 Recommendations for the management of hydrocele 12 3D ACUTE SCROTUM IN CHILDREN 13 3D.1 Epidemiology, aetiology and pathophysiology 13 3D.2 Diagnostic evaluation 13 3D.3 Disease management 14 3D.3.1 Epididymitis 14 3D.3.2 Testicular torsion 14 3D.3.3 Surgical treatment 14 3D.4 Follow-up 14 3D.4.1 Fertility 14 3D.4.2 Subfertility 14 3D.4.3 Androgen levels 15 3D.4.4 Testicular cancer 15 3D.5 (...) Recommendations for the treatment of acute scrotum in children 15 3E HYPOSPADIAS 15 3E.1 Epidemiology, aetiology and pathophysiology 15 3E.1.1 Risk factors 15 3E.2 Classification systems 15 3E.3 Diagnostic evaluation 16 3E.4 Disease management 16 3E.4.1 Age at surgery 16 3E.4.2 Penile curvature 17 3E.4.3 Preservation of the well-vascularised urethral plate 17 3E.4.4 Re-do hypospadias repairs 17 3E.4.5 Urethral reconstruction 18 3E.4.6 Urine drainage and wound dressing 18 3E.4.7 Outcome 18 3E.5 Follow-up 19 3E

2015 European Association of Urology

136. Neuro-urology

. Complications of neuro-urological symptoms (infections) account for a major cause of mortality in MSA [31]. Brain tumors 26.8/100,000/yr in adult (> 19 yrs) (17.9 benign, 8.9 malignant) [32]. Neuro-urological symptoms vary according to tumour location. Incontinence occurs mainly in frontal location (part of frontal syndrome or isolated in frontal location) [33]. Voiding dyfunction may occur in other location. Mental retardation and cerebral palsy Intellectual disability in children is a very heterogenous (...) group: including perinatal injury, materno- foetal infections, metabolic disease, genetic disorders and cerebral palsy Mental retardation other than cerebral palsy Cerebral Palsy: 3.1-3.6/1,000 in children aged 8 yrs [34]. Incontinence: In 65% of severe and profoundly retarded adult patients [35, 36]. DO and impaired contractility also reported. 89% incontinence, 70% uninhibited detrusor contraction at urodynamic examination. Recurrent urinary tract infection and radiologic abnormalities in > 10

2015 European Association of Urology

137. Urological Infections

measures 29 3E.5.2 Treatment 30 3E.5.2.1 Relief of obstruction 30 3E.5.2.2 Antimicrobial therapy 30 3E.5.2.3 Adjunctive measures 31 3F CATHETER-ASSOCIATED UTIs 31 3F .1 Introduction 31 3F .2 Methods 31 3F .3 Classification systems 31 3F .4 Diagnostic evaluation 32 3F .5 Disease management 32 3F .6 Summary of recommendations 32 3G UTIs IN CHILDREN 33 3G.1 Introduction 33 3G.2 Epidemiology, aetiology and pathophysiology 34 3G.3 Classification systems 34 3G.4 Diagnostic evaluation 35 3G.4.1 Physical (...) Uncomplicated UTI Local symptoms Dysuria, frequency, urgency, pain or bladder tenderness No symptoms ABU NO* CY-1 Empirical 3-5 days PN-2 PN-3 Febrile UTI Empirical + directed 7-14 days US-4 Empirical + directed 7-14 days Consider combining 2 antibiotics US-5 US-6 Empirical + directed 10-14 days Combine 2 antibiotics Dipstick (MSU Culture + S as required) General symptoms Fever, Flank pain Nausea, vomiting Dipstick MSU Culture + S Renal US or I.V. Pyelogram /renal CT Systemic response SIRS Fever, shivering

2015 European Association of Urology

140. UroLift for treating lower urinary tract symptoms of benign prostatic hyperplasia

noted no cases of urinary incontinence or sexual dysfunction. Minor complications included transient dysuria (70%) and urgency (40%), and slight haematuria (30%). Two patients (10%) needed post-operative catheterisation. The authors stated that longer follow-up times and larger patient numbers were needed before conclusions could be made on the safety and efficacy of the technology. An average of 3.8 UroLift implants was used per patient. 3.11 Chin et al. (2012) and Woo et al. (2012) both reported (...) reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 11 of 35some patients continued to show a 34% symptomatic improvement. Similar improvements were shown in BPHII and quality of life. Results were statistically significant for all of these outcomes at all time intervals. No decrease in sexual function was observed, and the MSHQ-EjD showed significant improvements at some intervals. Adverse events were minor, such as dysuria and haematuria

2015 National Institute for Health and Clinical Excellence - Medical technologies

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