Urinary Transport Disorder, Obstructive Uropathy, Refluxuropathy: Examination

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)]
  • 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.