Examination and Investigation of Sensory Patients

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).