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Dysuria in Children

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121. Chronic prostatitis and chronic pelvic pain syndrome

, inguinal or rectal regions. 17,22 In addition, they may report dysuria, or pain during or after ejaculation. 17 Findings from a retrospective analysis of clinical records (n=1,563) indicate that the most prevalent localisation for pain is the perineal region (63% of patients), followed by the testicular, pubic and penile areas. 10 Tenderness in the abdominal/pelvic region is also reported by patients with CP/CPPS, with the most common sites including the prostate and pelvic floor muscles. 23,24 (...) symptoms experienced by CBP and CP/CPPS patients. 25-27 Neuropathic pain is also a feature of CP/CPPS and is described in more detail in Box 1. LUTS are also a common clinical presentation, 4,22,28 with cohort studies reporting at least one such symptom in 39– 68% of patients. 4,29 LUTS include voiding symptoms (for example, weak stream, straining and hesitancy) or storage symptoms (for example, urgency with or without urgency incontinence, increased urinary frequency, nocturia and dysuria). 17,30

2015 Prostate Cancer UK

122. Warts - anogenital

lesions which may be misdiagnosed as anogenital warts include: Pearly penile papules. Benign molluscum contagiosum, skin tags, and seborrhoeic keratoses. Vulval, penile, or anal intraepithelial neoplasia, and frank malignancy. Anogenital condylomata lata of secondary syphilis. Referral to a sexual health specialist is recommended for all people with anogenital warts, especially: Women who are pregnant. Children (the possibility of sexual abuse should be considered). People who are immunocompromised (...) transmitted infection. Ask about: A new sexual partner. More than one sexual partner in the last year. Current and previous sexual partners. Use of barrier contraception. Ask about symptoms : In men, ask about the presence of urethral discharge and dysuria. In women, ask about vaginal discharge and intermenstrual or post-coital bleeding. Distortion of urine flow or bleeding from the urethra (suggesting an intrameatal wart) and bleeding from the anus. Examine the external genitalia , perianal area

2017 NICE Clinical Knowledge Summaries

123. Herpes simplex - genital

are usually bilateral and develop 4–7 days after exposure to HSV infection. People may complain of dysuria, vaginal or urethral discharge, and systemic symptoms such as fever and malaise. A primary episode can last up to 20 days, and is often more severe than a recurrent episode. Following primary infection, the virus becomes latent in local sensory ganglia. Recurrent genital herpes refers to a recurrence of clinical symptoms due to reactivation of pre-existent HSV infection after a latent period. People (...) of genital herpes and exclude other causes of genital ulceration. Take a brief sexual history , and ask about: Age — there is an increased risk in those aged under 25 years. Previous sexually transmitted infections (STIs). A new sexual partner. More than one sexual partner in the last year. Current and previous sexual partners. Use of barrier contraception. Ask about the onset and duration of symptoms , including: Presence of painful ulcers. Dysuria, vaginal or urethral discharge. Malaise, or fever

2017 NICE Clinical Knowledge Summaries

124. Incontinence - urinary, in women

if the woman: Is aged 45 years and over with unexplained visible haematuria without urinary tract infection, or visible haematuria that is persistent or recurrent after successful treatment of urinary tract infection, or Is aged 60 and over with unexplained non-visible haematuria and dysuria or a raised white cell count on a blood test. Women with stress incontinence should be referred for a trial of at least 3 months' supervised pelvic floor muscle training. If this fails, referral for assessment (...) ) guidance Urinary incontinence and pelvic organ prolapse in women: management [ ]. This CKS topic covers the primary care management of stress urinary incontinence, urgency urinary incontinence (which may be associated with overactive bladder), and mixed urinary incontinence in women. This CKS topic does not cover the specialist management of urinary incontinence in women or the management of urinary incontinence in men, or children. There are separate CKS topics on , , , and . The target audience

2017 NICE Clinical Knowledge Summaries

125. Candida - female genital

(usually white, 'cheese-like', and non-offensive), superficial dyspareunia, and dysuria. Signs may include vulvovaginal inflammation and erythema, vaginal fissuring, and excoriation of the vulva. Microscopy and fungal culture of vaginal secretions to identify yeasts is only recommended for supporting the diagnosis and in cases of severe or recurrent vulvovaginal candidiasis, or treatment failure. Treatment of uncomplicated infection involves: A short course of an intravaginal antifungal (...) (usually white, 'cheese-like', and non-malodorous). Superficial dyspareunia. Dysuria (pain or discomfort during urination). Enquire whether the infection is: An isolated episode, or A recurrence (defined as four or more documented episodes in 1 year, with at least partial resolution of symptoms between episodes), or Treatment failure (failure of symptoms to resolve within 7–14 days of treatment). Ask about any treatments that have been tried already, including over-the-counter treatments. Enquire about

2017 NICE Clinical Knowledge Summaries

127. 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

128. 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

129. 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

131. Joint Hypermobility - Identification and Management of

Joint Hypermobility - Identification and Management of Evidence-Based Care Guideline for Management of Pediatric Joint Hypermobility Guideline 43 Copyright © 2014 Cincinnati Children's Hospital Medical Center, all rights reserved. Page 1 of 48 James M. Anderson Center for Health Systems Excellence Evidence-Based Care Guideline Identification and Management of Pediatric Joint Hypermobility In children and adolescents aged 4 to 21 years old a Publication Date: October 21, 2014 Target Population (...) Inclusions: Children and adolescents: ? With joint hypermobility ? 4 to 21 years old ? Less than 4 years old with a family history of hypermobility Exclusions: Children and adolescents with: ? Greater than mild hypotonia ? Spasticity ? Progressive neuromuscular conditions Target Users Including but not limited to: ? Dentists/Orthodontists ? Nurses ? Nurse Practitioners ? Occupational Therapists ? Physical Therapists ? Psychologists ? Physicians ? Geneticists ? Orthopedists ? Primary Care Physicians

2014 Cincinnati Children's Hospital Medical Center

132. Diagnosis and Treatment Interstitial Cystitis/Bladder Pain Syndrome

the diagnosis, the mean age is older than is typical for the US. A history of a recent culture-proven UTI can be identified on presentation in 18-36% of women, although subsequent cultures are negative. 17, 18 Initially it is not uncommon for patients to report a single symptom such as dysuria, frequency, or pain, with subsequent progression to multiple symptoms. 19, 20 Symptom flares, during which symptoms suddenly intensify for several hours, days, or weeks, are not uncommon. There is a high rate of prior (...) of Children's Hospitals and Related Institutions, and various private data sets between 1994 and 2000 revealed an increase of 29% from $37 to $66 million among persons with a formal diagnosis of IC/BPS. Similarly, the direct annual costs associated with BPS rose from $481 million to $750 million (amounts standardized to 1996-1998 values). 46 Between 1992 and 2001 the rate of visits to physician's offices increased three-fold and the rate of visits to hospital outpatient visits increased two-fold. 46 Only

2014 American Urological Association

134. Dapagliflozin (Forxiga) in type 2 Diabetes Mellitus. Urinating glucose has its problems

or insulin). Frequent (1/100 to <1/10): Vulvovaginitis, balanitis and genital infections, urinary tract infections, back pain, dysuria, polyuria, dyslipidaemia, increase in he- matocrit. Less frequent (1/1.000 to <1/100): Vulvovaginal pruritus, volume depletion, thirst, constipation, hyperhidrosis, nicturia, increase in blood creatinin levels, increase in blood urea. 1,2 The incidence of adverse effects with dapa- gliflozin in monotherapy was 22% compared to 15% under metformin. Severe adverse effects (...) a year. Renal function should be monitored befo- re initiating treatment with drugs that can affect its function and thereafter regularly. If ClCr<60 mL/min or GFR<60 mL/min/1.73 m 2 then treatment should be stopped. 1,2 Li- ver failure: in cases of severe liver failure, the initial recommended dose is 5 mg daily, and if well tolerated it can be increased up to 10 mg. No dose adjustments are required for mild and moderate live impairment. 1,2 Children: there are no data in children under 18 year

2014 Drug and Therapeutics Bulletin of Navarre (Spain)

135. Management of Trichomonas vaginalis infection

] ? 10-50% are asymptomatic. ? The commonest symptoms include vaginal discharge, vulval itching, dysuria, or offensive odour, but these are not specific for TV. ? Occasionally the presenting complaint is of low abdominal discomfort or vulval ulceration. Males [4-6] ? 15 to 50% of men with TV are asymptomatic and usually present as sexual partners of infected women. ? The commonest presentation in symptomatic men is with urethral discharge and/or dysuria. ? Other symptoms include urethral irritation (...) examination. ? 5-15% of women will have no abnormalities on examination. Males [4-6] ? Urethral discharge (20-60% men) - usually small or moderate amounts only, and or dysuria. ? No signs, even in the presence of symptoms suggesting urethritis: one recent prospective study of infected TV contacts found 77.3% were asymptomatic. ? Rarely balanoposthitis. 3 Complications There is increasing evidence that TV infection can have a detrimental outcome on pregnancy and is associated with preterm delivery and low

2014 British Association for Sexual Health and HIV

137. 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

138. Atopic dermatitis – Treatment with phototherapy and systemic agents

Department of Dermatology, Seattle Children's Hospital, Seattle, Washington , MD (Co-chair) a , x Dawn M. Davis Affiliations Department of Dermatology, Mayo Clinic, Rochester, Minnesota , MD b , x David E. Cohen Affiliations Department of Dermatology, New York University School of Medicine, New York, New York , MD c , x Kelly M. Cordoro Affiliations Department of Dermatology, University of California, San Francisco, California , MD d , x Timothy G. Berger Affiliations Department of Dermatology (...) , x Wynnis L. Tom Affiliations University of San Diego, San Diego, California Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital, San Diego, California , MD m , n , x Hywel C. Williams Affiliations Center of Evidence-based Dermatology, Nottingham University Hospitals National Health Service Trust, Nottingham, United Kingdom , DSc o , x Craig A. Elmets Affiliations Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama , MD p , x Julie Block

2014 American Academy of Dermatology

139. Suprapubic urinary catheter

record ( ). The child’s doctor must be informed if the child: is unable to pass urine ( ) has dysuria ( ) if the entry site leaks on their first micturition The entry site must be observed for haemorrhage and urine leakage ( ). If either occurs, pressure must be applied and the child’s doctor informed ( ). The dressing should be removed after 24 hours ( ). Once the site is healed a dressing will no longer be required. The appropriate children’s community nursing team must be informed on admission (...) Suprapubic urinary catheter Suprapubic urinary catheter | Great Ormond Street Hospital Google Tag Manager Navigation Search Search You are here Suprapubic urinary catheter Suprapubic urinary catheter ). The procedure is carried out using an aseptic technique and in children and young people is usually performed under a general anaesthetic. In life threatening situations or acute retention of urine, a suprapubic catheter may however, be inserted under local anaesthetic. The suprapubic catheter

2014 Publication 1593

140. Hematuria in an Adult with Congenital Heart Disease. (PubMed)

Hematuria in an Adult with Congenital Heart Disease. Adults with congenital heart disease (CHD) in the United States now outnumber children with CHD, due in part to the improvement in surgical and medical management. This growing population may present postoperatively to the emergency department (ED) with nonspecific complaints from unforseen complications secondary to cardiac intervention.We describe a 39-year-old male who presented to the ED with hematuria and dysuria after he underwent (...) , the patient's initial presentation of hematuria and dysuria presented a unique diagnostic challenge. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Patients with underlying CHD require emergency physicians to consider a multidisciplinary approach to properly diagnose and facilitate treatment.Copyright © 2017 Elsevier Inc. All rights reserved.

2018 Journal of Emergency Medicine

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