Examination and Investigation of Sensory Patients

  • N. J. R. George
  • P. H. Powell

Abstract

A full clinical examination will be required of the patient suspected of having a sensory disorder in order to identify organic pathology, which has first to be excluded as a cause of symptoms (Fig. 4.1). Rectal examination is instructive as an assessment of pelvic floor muscle tension since in many apprehensive patients, particularly males suspected of having prostatodynia, the muscular contraction of the pelvic floor is particularly evident (Segura et al. 1979). Routine haematological and biochemical screening should be undertaken and special attention directed towards the accurate collection of fractionated urine samples. These collections and the necessary urethral swabs for virology and special culture must be carefully planned. The investigation schedule for the collection of specimens from patients referred to the urological out-patient clinic is illustrated in Fig. 4.2. Full descriptions of the investigation techniques are given in the appropriate sections on the urethral syndrome (Chap. 11) and prostatodynia (Chap. 15). Radiographs will be generally unhelpful though chest X-ray and plain abdominal film including kidneys, ureters and bladder should be requested to help exclude other organic disease. Intravenous urography reveals few unexpected abnormalities in these patients but nevertheless it seems likely that the examination will continue to be performed on an empirical basis (Carson et al. 1980).

Keywords

Burning Catheter Depression Agar Platinum 

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References

  1. Carson CC, Segura JW, Osborne DM (1980) Evaluation and treatment of the female urethral syndrome. J Urol 124: 609–610PubMedGoogle Scholar
  2. Emmett JL, Daut RV, Dunn JH (1948) Role of the external urethral sphincter in the normal bladder and cord bladder. J Urol 59: 439–454PubMedGoogle Scholar
  3. Frimodt-Mdller C (1972) A new method for quantitative evaluation of bladder sensibility. Scand J Urol Nephrol 6 (Suppl. 15): 135–142CrossRefGoogle Scholar
  4. George NJR (1978) Influence of lignocaine on bladder instability. Paper presented at the VHIth meeting of the International Continence Society. ManchesterGoogle Scholar
  5. Hald T (1969) Neurogenic dysfunction of the urinary bladder. Thesis, University of CopenhagenGoogle Scholar
  6. Higson RH, Smith JC, Hills W (1979) Intravesical lignocaine and detrusor instability. Br J Urol 51: 500–503PubMedCrossRefGoogle Scholar
  7. Kaplan WE, Firlit CF, Schoenberg HW (1980) The female urethral syndrome: external sphincter spasm as etiology. J Urol 124: 48–49PubMedGoogle Scholar
  8. Keele CA (1966) Touch, heat and pain. Ciba Foundation Symposium, Churchill, LondonGoogle Scholar
  9. Kiesswetter H (1977) Mucosal sensory threshold of the urinary bladder and urethra measured electrically. Urol Int 32: 437–448PubMedCrossRefGoogle Scholar
  10. Klevmark B (1981) Hyperactive neurogenic bladder studied with physiological filling rates. Scand J Urol Nephrol (Suppl) 60: 55–56Google Scholar
  11. Murray K (1982) Urethral sensitivity—An integral component of the storage phase of the micturation cycle. Neurol Urodyn 1: 193–197CrossRefGoogle Scholar
  12. Opsomer RJ, Gerstenberg TC, Klarskov P, Hald T (1983) The electric sensibility threshold in the bladder and the urethra. Paper presented at the XHIth meeting of the International Continence SocietyGoogle Scholar
  13. Powell PH, Feneley RCL (1980) The role of urethral sensation in clinical urology. Br J Urol 52: 539–541PubMedCrossRefGoogle Scholar
  14. Powell PH, Yeates WK (1982) The clinical value of bladder capacity measurement at physiological pressure under anaesthesia Br J Urol 54: 650–652Google Scholar
  15. Raz S, Smith RB (1976) External sphincter spasticity syndrome in female patients. J Urol 115: 443–446PubMedGoogle Scholar
  16. Segura JW, Opitz JL, Greene LF (1979) Prostatosis, prostatitis or pelvic floor tension myalgia? J Urol 122: 168–169PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1986

Authors and Affiliations

  • N. J. R. George
  • P. H. Powell

There are no affiliations available

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