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Atallah A. Shaaban<br />
9<br />
Urologic Symptoms<br />
<strong>Basic</strong> <strong>Urology</strong><br />
I. Pain:<br />
Pain within the genitourinary tract usually arises from obstruction<br />
or inflammation. Referred pain is common. Inflammation of parenchyma<br />
produces severe pain and fever e.g. acute pyelonephritis, prostatitis and<br />
epididymo-orchitis. Tumors usually do not cause pain unless they<br />
produce obstruction or extend to adjacent nerves.<br />
1- Renal pain:<br />
It results from obstruction of urine flow<br />
with distension of the capsule or the<br />
collecting system.<br />
Pain due to inflammation is dull aching.<br />
It is felt in the posterior renal (costovertebral)<br />
angle, below the last rib and<br />
lateral to the sacrospinalis.<br />
Pain radiates from the loin to the groin<br />
and ipsilateral testis or labium (Fig. 2).<br />
It is associated with gastrointestinal<br />
Fig. (2): Location and<br />
symptoms: nausea, vomiting and distension.<br />
radiation of renal pain<br />
Differential diagnosis: Radicular pain:<br />
- It results from irritation of costal nerves most commonly T 10 -T 12 .<br />
- Not colicky.<br />
- It is felt in the renal angle and radiates towards the umbilicus.<br />
- The intensity is altered by changing the position.
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