Urology Book

Testicular Disorders

Urinary Bladder Disorders

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Dysuria in Women

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  1. See Also
    1. Dysuria
    2. Dysuria in Men
    3. Urinary Tract Infection
  2. Causes
    1. See Dysuria for non-gender specific causes
    2. Urinary Tract Infection
      1. Acute Cystitis
      2. Pyelonephritis
    3. Genital Herpes (HSV II)
    4. Urethritis
      1. Gonorrhea
      2. Chlamydia
    5. Vulvodynia
    6. Vaginitis
      1. Candidal Vaginitis
      2. Trichomonas Vaginitis
      3. Atrophic Vaginitis (post-Menopause)
    7. Interstitial Cystitis
    8. Urethral Syndrome
      1. Acute Cystitis symptoms and normal urine
    9. Contact Dermatitis
      1. Vaginal Douche
      2. Vaginal lubricant
      3. Spermicidal gel
      4. Contraceptive foams or sponges
      5. Tampons
      6. Sanitary napkins
      7. Perfumed soap
      8. Toilet paper
  3. Symptoms and Signs
    1. See Urinary Tract Infection
    2. See Vaginitis
    3. See Vaginal Discharge
    4. See Dyspareunia
  4. Evaluation
    1. Urine Sample
      1. Urinalysis
      2. Urine Culture
      3. Dysuria with negative Urine Dipstick and culture
        1. 75% Respond to trimethoprim (25% for Placebo)
        2. Richards (2005) BMJ 331:143
    2. Vaginitis suspected: Vaginal Discharge examination
      1. KOH Preparation
      2. Saline Preparation (Wet Prep)
    3. Sexually active patient
      1. Routine swab for Gonorrhea and Chlamydia
      2. Consider Gram Stain of cervical discharge
  5. Management: Empiric for urethritis if testing negative
    1. Consider treating for Ureaplasma
    2. Metronidazole 2 g PO and
    3. Erythromycin
      1. Erythromycin Base 500 mg PO qid for 7 days or
      2. Erythromycin ethylsuccinate 800 mg PO qid for 7 days
  6. References
    1. Kurowski (1998) Am Fam Physician 57(9):2155
    2. Roberts (1999) Am Fam Physician 60(3):865

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