large number of patients undergo urological examination regarding complaints of pain in the abdomen, in its lateral parts in the back.The pain associated with renal impairment may be caused by various reasons.The stones, which are located in the kidney or ureter, causing pain in the urinary tract obstruction with subsequent development of hydronephrosis.
When the pressure inside the closed urinary tract and kidney capsule tension pain impulses arise.Stones can occur in the urinary system and reach a considerable size, without causing pain, provided that there is no obstruction or if it develops slowly (with coral stones, and chronic urinary infections caused by microorganisms that break down urea).
appearance of renal pain may result in kidney infection, acute pyelonephritis, renal or perinephric abscess.Papillary necrosis can also cause considerable pain as kidney ischemia, especially if the process begins acutely.When blunt trauma of kidney pain may be in the soft tissues later
pain emanating from the kidney, there is a patient in the edge-vertebral angle or more diffusely over the lateral surface of the body or in the upper quadrant of the abdomen.
Pain in the lower abdomen may be due to urological causes, such as urinary retention, bladder irritation or injury.
Abdominal pain neurologicheskogo nature can simulate kidney.The most common neurologicheskimi causes of abdominal pain that can be mistaken for the pain of urological origin are cholelithiasis, cholecystitis, diverticulitis, colon abscess in the retroperitoneal tissue and tumor located in the abdominal cavity.
muscular back pain and neurological pain caused by lesion of the intervertebral disc, the pain may resemble a kidney.
pain and the appearance of swelling in the genital area
pain in the scrotum
Testicular torsion is the most acute of all the pathological conditions of the scrotum.It is very important to accurately diagnosis and attention to the patient, since the rate of treatment determines the chances of saving the testicle.Getting most acute pain and may be (but not necessarily) associated with physical activity.
If untreated, the pain decreases a little, but after a few days, a new peak of pain due to an increase in edema and inflammation.If untreated, the process leads to tissue necrosis with their melting and formation of an abscess or progressive organ atrophy.
When epididymitis pain usually increases gradually at first and at first localized in the posterolateral portion of the scrotum.The young men in history is often marked by infection with a sexually transmitted disease or concomitant symptoms of urethritis.
In patients younger than 35 years, the most common causative agent of epididymitis is Chlamidia trachomatis, while, as intestinal bacteria (eg, E. Coli) are more common in patients older than 35 years.In the latter group, especially in men over age 50, the symptoms of bladder outlet obstruction can co-exist with the clinical picture of epididymitis, with pathophysiological processes looks like a violation of the act of emptying the bladder, and as a result of infection, rising to the epididymis.It is important to rule out urinary retention in the bladder by palpation, percussion or other methods (USG).
With booming epididymitis symptoms such as localized induration of the epididymis, and pain on palpation, may not be detected, and physical examination findings are the same as in the late phase of testicular torsion.At this stage, the study showed the intensity of blood supply to the testicles, sometimes - trial surgery.After the end of the inflammatory process can study blood flow, retrograde urethrography or cystoscopy.
On examination, the scrotum are identified as: redness, the appearance of the skin of the scrotum areas with inactive skin, floating, crepitus or pus.
testicular tumors classically looks like a painful swelling of the testicles within.In fact, 95% of the increase is an increase in testicular cancer, while the vast majority of tumors located outside eggs are benign.At the slightest suspicion of a tumor (within or outside the egg) the patient should immediately be referred to a urologist.
strangulated inguinal hernia may look like a tumor, detectable in the scrotum.On examination, can detect thickening at the base of the scrotum, which will be located hernial sac, down from the external opening of the inguinal canal into the scrotum.
Other benign scrotal - hydrocele, varicocele and spermatoceles.
pain in the penis and urethra
penis Pain may also occur as a result of vascular disorders and infections.Inflammation exciting head or preputial sac, called, respectively, balanitis and postitom or together (balanoposthitis).Treatment is carried out without difficulty by appointing per os antibiotic broad spectrum of action and conduct thorough local hygiene measures.
Balanitis xerotica obliterans - a chronic process in which it may be expressed induration and chronic inflammation of the glans and prepuce.
penile pain due to circulatory disorders may be accompanied by the appearance of zones of necrosis and ischemia on the head and is more common in diabetics.
pain in the urethra can be described as dysuria or burning during urination, and be constant or occur intermittently.Urethritis may be due to chemical, traumatic or infectious agents.With infectious urethritis possible discharge from the urethra.
sexually transmitted diseases ranging from significant lesions (eg warts) to painful blisters on the skin of the genital organs (as in herpes infection).Syphilis, gonorrhea and lymphogranuloma venereum groin may appear respectively Shankar, dysuria, or lymphadenopathy.
Pain in the prostate
If you feel pain in the perineum or in the zone of the prostate should be excluded infection, inflammation, tumor, or neurogenic dysfunction of the body.The pain often occur in younger men.Prostatodynia - complaints of pain associated with the prostate gland, in the absence of pathological changes of the body.It requires consultation urologist and neuropsychiatrist.
pathological phenomena when urinating
Symptoms of obstruction
Symptoms of obstruction during urination involves uncertainty (very weak urge), urination intermittently excess voltage in the commission of an act of urine drop by drop upon completion of urination, reducing powerand the thickness of the jet, as well as a feeling of incomplete emptying of the bladder.These symptoms indicate an obstruction in the cervical portion of the urethra.
pathological phenomena when urinating
Signs of obstruction
signs of irritation
most common etiologic factors are benign prostatic hyperplasia, prostate cancer, it urethral strictureand contraction of the bladder neck.
complaints related to sexual organs
addition to the above lesions (pain or swelling in the scrotum), patients may complain of chronic or pinch discomfort, pain in the testicles of different severity.In the absence of any correlation between the complaints and the results of physical examination, think of such pathological conditions as varicocele, orchitis, testicular atrophy, referred pain, or mental illness.
penis, which is smaller than the norm by more than 2 sigma (2 standard deviation) is called micropenis.Normally, a baby's penis - 1.5 cm. A child 2-4 years is equal to 3.3 cm in adults - 12.4 cm.If inadequate response to the length of the penis of the patient should be referred to a therapist or urologist.
complaints related to sexual dysfunction can include loss of Libido.Erectile dysfunction, ejaculation disorder, pain in the genital area and the deformation of the penis during intercourse.
loss of sexual desire can have psychological causes, and may be associated with disorders of the endocrine system.For proper evaluation of the cause of loss of Libido and impotence associated with a weak erection, it is necessary to build a complete general and neurological history and conduct appropriate laboratory tests.
Blood found in the ejaculate often, and usually does not indicate the presence of malignancy, but causes a lot of anxiety in the patient.With it should be carried out psychotherapeutic conversation, but again, the appearance of blood - referral to a urologist to rule out rare but very serious disease (chronic infections, tumors and others.).