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Clinical Evaluation: History Taking and Urological, Gynaecological and Neurological Evaluation

  • Cevdet Kaya
  • Christian Radmayr
Chapter
First Online:
Part of the Urodynamics, Neurourology and Pelvic Floor Dysfunctions book series (UNPFD)

Abstract

Most children referred for urodynamic studies already have specific pathological diagnoses such as spinal dysraphism, spinal cord injury or cerebral palsy as well as voiding dysfunction. When paediatric urologists need to evaluate a child, an understanding of the main complaints, a detailed medical history as well as a focused physical examination are essential for setting up an appropriate management strategy for these patients. The comprehensive history should reflect the general health status in addition to a specific voiding and defecation history. Frequency-volume charts, voiding diaries, and symptom scores will be helpful for a sufficient workup. Physical examination should cover the inspection and palpation of the abdomen, genitalia and with special attention the back of the child. While urological examination focuses on external genitalia, neurological examination includes the assessment of perineal sensation, the perineal reflexes from the sacral segments and anal sphincter tone and control. Asymmetry of the buttocks, legs or feet and other signs of occult spinal dysraphism in the lumbosacral area have to be investigated carefully. Gynaecological examination can provide important information on external genitalia as well as the introitus, the urethral meatus and the perineum.

Keywords

Urologic dysfunction Evaluation Spinal dysraphism Urinary tract Lower urinary tract symptoms Bladder Voiding diary Spinal cord injury Incontinence Constipation 
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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Urology, School of MedicineMarmara UniversityIstanbulTurkey
  2. 2.Department of Urology, School of MedicineInnsbruck UniversityInnsbruckAustria

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