Symptom Finder - Strangury
STRANGURY
This is the constant or almost constant desire to urinate. The differential diagnosis may be developed around the mnemonic MINT.
M—Malformations include urethral stricture, retroverted uterus, and prolapse of the uterus and bladder.
I—Inflammatory conditions include bacterial cystitis, urethritis, Bilharziasis, intestinal cystitis, gonorrhea, inflamed hemorrhoids, and anal fissure.
N—Neoplasms include carcinoma of the bladder or prostate, uterine fibroids or carcinoma, and carcinoma of the rectum extending into the bladder. N also helps to recall neurologic conditions that cause strangury, especially tabes dorsalis and chronic anxiety states or hysteria.
T—Trauma would help to recall contusion or laceration of the bladder, rectum, or urethra.
Approach to the Diagnosis
A CBC, urinalysis, urine culture, and sensitivity and chemistry panel will routinely be ordered. It is well to do a smear and culture of any vaginal or urethral discharge. If these tests are negative, an urologist needs to be consulted for a cystoscopic examination possibly with retrograde pyelography. A vaginal and rectal examination must be done in all cases but is often neglected.
This is the constant or almost constant desire to urinate. The differential diagnosis may be developed around the mnemonic MINT.
M—Malformations include urethral stricture, retroverted uterus, and prolapse of the uterus and bladder.
I—Inflammatory conditions include bacterial cystitis, urethritis, Bilharziasis, intestinal cystitis, gonorrhea, inflamed hemorrhoids, and anal fissure.
N—Neoplasms include carcinoma of the bladder or prostate, uterine fibroids or carcinoma, and carcinoma of the rectum extending into the bladder. N also helps to recall neurologic conditions that cause strangury, especially tabes dorsalis and chronic anxiety states or hysteria.
T—Trauma would help to recall contusion or laceration of the bladder, rectum, or urethra.
Approach to the Diagnosis
A CBC, urinalysis, urine culture, and sensitivity and chemistry panel will routinely be ordered. It is well to do a smear and culture of any vaginal or urethral discharge. If these tests are negative, an urologist needs to be consulted for a cystoscopic examination possibly with retrograde pyelography. A vaginal and rectal examination must be done in all cases but is often neglected.
