ISSN 2398-2942      

Dysuria investigation

icanis
Contributor(s):

Kyle Braund

Kathy Lunn


Introduction

  • Dysuria is defined as painful and/or difficult urination.
  • Clinical evaluation of urinary function can be accomplished by a series of diagnostic procedures.
  • Physical examination and a complete history of the patient are important in the diagnosis of urinary tract disease.
  • Observation of the patient during urination is very helpful.
  • Signs may be due to urinary tract disease or extra-urinary structures impinging on urinary tract.
Is it likely that the patient has urinary tract disease?Signalment
  • Age:
    • Young: increased likelihood of congenital disease.
    • Adult: consider urethral obstruction Urethra: obstruction or prostatomegaly in male Prostate disease , and urinary tract infection, particularly in female.
    • Geriatric: may have neoplastic obstruction Urethra: neoplasia.

Clinical signs

  • Non-productive straining.
  • Signs of pain while urinating.
  • Hematuria.
  • Frequent attempts to urinate.
  • Passage of small amounts of urine.
    Care not to confuse fecal tenesmus with urinary straining.
  • Systemic signs:
    • Depression (if obstructed).
    • Constipation or straining to defecate (associated with prostatomegaly).

Clinical examination

  • Palpation of bladder size and shape:
    • Palpate urethra per rectum.
    • Empty bladder may indicate poor filling or bladder irritation.
    • Large bladder may indicate outflow obstruction.
  • Palpation of prostate for evidence of enlargement.
  • Palpate bladder before and after urination.
  • Observe urine stream during urination.

Causes of dysuria

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Imaging

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Laboratory investigation

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Prognostic indicators

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Johnston S D, Kamolpatana K, Root-Kustritz M V et al (2000) Prostatic disorders in the dog. Anim Reprod Sci 60-61, 405-415 PubMed.
  • Díaz Espiñeira M M, Viehoff F W, Nickel R F et al (1998) Idiopathic detrusor - urethral dyssynergia in dogs: a retrospective analysis of 22 dogs. JSAP 39 (6), 264-270 PubMed.
  • Longshore R C, O'Brien D P, Johnson G C et al (1996) Dysautonomia in dogs: a retrospective study. J Vet Int Med 10 (3), 103-109 PubMed.

Other sources of information

  • Lees G E (2000) Incontinence, enuresis, dysuria and nocturia. In: Textbook of Veterinary Internal Medicine. 5th edn. Eds: S J Ettinger & E C Feldman. Philadelphia: W B Saunders. pp 89-92. ISBN 0808921754.

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