Dysuria with a Negative Urine Culture or When is a UTI not a UTI?

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Sources of female urinary incontinence • Stress leakage: increase in intraabdominal pressure > sphincter closure mechanisms in the absence of a bladder contraction – Birth trauma – Age/tissue atrophy • Uninhibited detrusor contractions – Age – Idiopathic – Neurologic conditions (MS, stroke)
Distinguishing stress from urge • History: frequency, dysuria, nocturia, onset, course, ppts, meds, prior rx, volume lost • PE: prolapse, estrogen deficiency • Cough test – Immediate leakage : failure of sphincter action – delayed leakage that is difficult to stop: coughinduced uninhibited detrusor contraction
Page 1 and 2: Women’s Health Clinical Pearls 20
Page 3 and 4: Case 1: ovarian cancer screening
Page 5 and 6: • elevated in CA-125 - ~50% of wo
Page 7 and 8: Under active investigation • Chan
Page 9 and 10: Case 2: family history of ovarian
Page 11 and 12: 1. BRCA 1/BRCA2 testing 2. BRCA 1/B
Page 13 and 14: Who should have additional testing/
Page 15 and 16: Pearls: family history of ovarian C
Page 17 and 18: Her most likely diagnosis? 1. bladd
Page 19 and 20: What can we learn from physical •
Page 21 and 22: Dysuria Pearls • Culture 2nd epis
Page 23: Her most likely diagnosis is: 1. St
Page 27 and 28: Incontinence pearls • No meds mak
Page 29 and 30: Reason patient would be offended if
Page 31 and 32: •
Page 33 and 34: Clinical pearls: what to do if she
Page 35 and 36: What should you do? 1. Prescribe th
Page 37 and 38: Obesity and contraception • In ob
Page 39 and 40: Pearls: pills for obese women • E
Page 41 and 42: How do you manage this patient? 1.
Page 43 and 44: Refractory vulvovaginitis • Persi
Page 45 and 46: Vaginal discharge pearls • Someti
Page 47 and 48: When should she have her next mammo
Page 49 and 50: Mortality reduction • Excellent e
Page 51 and 52: Younger women: screening interval c

Dysuria with a Negative Urine Culture or When is a UTI not a UTI?

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