A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body temperature, body weight, body height; further:
- Inspection (viewing).
- Skin and mucous membranes
- Auscultation (listening) of the heart
- Auscultation of the lungs
- Palpation (palpation) of the abdomen (abdomen) (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, kidney bearing knocking pain?)
- Palpation of the renal region [feeling of pressure in the area of the kidney due to urinary retention].
- Digital rectal examination (DRU): examination of the rectum (rectum) and adjacent organs with the finger by palpation: assessment of the prostate in size, shape and consistency [prostatic hyperplasia (BPH) (benign prostate enlargement)]
- Inspection (viewing).
- Cancer screening[due topossible causes or differential diagnoses:
- Metastases (daughter tumors) of various solid tumors.
- Tumors of the pelvis such as cervical carcinoma (cancer of the cervix).
- Tumors of the genitourinary tract such as prostate carcinoma (prostate cancer).
- Uterine fibroids (benign neoplasm in the uterus)]
- If necessary, neurological examination[due topossible causes or differential diagnoses:
- Multiple sclerosis (MS) – neurological disease that can lead to paralysis.
- Paraplegia (transverse paralysis) – paralysis of both arms or both legs]
- Urological/nephrological examination[due topossible causes:
- Obstructive uropathy (congenital ureteral and urethra narrowing (stenoses and strictures, respectively)).
- Vesicorenal reflux (congenital reflux is based on malposition of the ureteral orifice in the bladder wall)]
[due topossible differential diagnoses:
- Pelvic floor slump
- Blood coagulation in hematuria (blood in the urine)
- Endometriosis (benign but painful proliferation of endometrium) (endometrium) outside the uterine cavity.
- Ureteral stricture (narrowing of the ureter).
- Megaureter (usually congenital dilation of one or both ureters (>10 mm)).
- Cicatricial strictures (high-grade narrowing) of the urinary tract
- Kidney stone
- Prostatic hyperplasia (BPH) (benign prostatic enlargement).
- Retroperitoneal fibrosis (synonyms: retroperitoneal fibrosis; Ormond’s disease; Ormond’s syndrome; in Anglo-American writing: Albarran-Ormond syndrome, “Gerota’s fascitis” or “Gerota’s syndrome”) – slowly increasing connective tissue proliferation between the posterior peritoneum (peritoneum) and the spine with walled-in vessels, nerves and ureters (ureters).
- Ureterocele (protrusion of the mucosa of the intramural ureteral segment into the bladder lumen).
- Ureteral stone (ureteral stone)
- Urolithiasis (urinary stone disease), unspecified]
[due topossible sequelae:
- Urinary stone formation (urolithiasis / nephrolithiasis).
- Urinary tract infection (UTI)
- Hydronephrosis (water sac kidney) – irreversible, sac-like expansion of the renal cavity system associated with destruction of kidney tissue.
- Renal dysfunction to renal insufficiency (renal weakness/renal failure)]
Square brackets [ ] indicate possible pathological (pathological) physical findings.