Pollakiuria

Age: ‍ years old

Gender: ‍malefemale



HISTORY:

Presents with a ‍-‍day history of urinary frequency

Described as a need to urinate every ‍ ‍minuteshours, ‍very smallsmallnormallarge volume

Pattern ‍persistentintermittent

Occurs most frequently during the ‍day



Associated symptoms: *Try using right-click for negatives*

‍dysuria

‍urgency

‍foul-smelling urine

‍hematuria

‍suprapubic pressure

‍abdominal pain, ‍diffuse, ‍dull, ‍mild

‍flank pain

‍fever, up to ‍°, over ‍ ‍hoursdays

‍chills

‍nausea

‍vomiting, ‍ episodes ‍per day, ‍, ‍hematemesis

‍incontinence

‍hesitancy

‍nocturia



Contributing factors:

‍pregnancy

‍high fluid intake

‍high caffeine intake

‍high alcohol intake

‍exposure to stress

no history of: ‍urinary tract infections, ‍benign prostatic hyperplasia, ‍interstitial cystitis, ‍overactive bladder syndrome, ‍urinary stones, ‍diabetes mellitus, ‍nervous system conditions

no use of: ‍diuretics, ‍new medication





EXAM:

General appearance: ‍well-appearing, ‍apparent distress

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Neck: ‍normal, ‍lymphadenopathy, ‍, c-spine ‍

Heart: ‍RRR, ‍MRG, ‍normal S1 and S2

Lungs: ‍clear bilaterally, ‍abnormal sounds, ‍retractions

Abdomen: ‍soft, ‍non-tender ‍, ‍non-distended, ‍guarding, bowel sounds ‍normal, ‍, ‍CVA tenderness ‍

Pelvic: external genitalia ‍normal, vagina ‍normal, cervix ‍normal, uterus ‍normal, adnexa ‍normal, ‍cervical motion tenderness

Genital: penis ‍normal, testes and epididymis ‍normal, ‍inguinal hernia





ASSESSMENT:

‍Urinary tract infection ‍likelysuspectedpossible

DDx: urinary tract infection, lower urinary tract symptoms, overactive bladder, hyperglycemia, interstitial cystitis, prostatitis, diuretic use, excessive fluid intake, caffeine consumption, alcohol consumption, bladder stones, bladder cancer, neurogenic bladder, benign prostatic hyperplasia, pelvic floor weakness, anxiety or stress-related disorders, medication side effect, pregnancy, menopause, hypercalcemia, sexually transmitted infection, urethral stricture, constipation, pelvic organ prolapse, cystocele, vaginal atrophy, neurological condition





PLAN:

Investigations:

- Urinalysis

- Urine culture

- Blood work: ‍CBC, ‍creatinine, ‍glucose

- Bladder scan

- Pelvic ultrasound

- Cystoscopy

- Post-void residual urine volume

Treatments:

- ‍Antibiotics

- ‍Overactive bladder medications

- ‍Alpha-blockers

- Stop medications that may contribute to urinary frequency, such as diuretics

- Reduce fluid intake

- Avoid caffeine and alcohol

- Voiding diary

- Pelvic floor exercises

Further care:

- Referral to urologist

- Follow-up in ‍ ‍weeksmonths

- Return if symptoms worsen or if fever develops