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Patient Presentations Related to the Genitourinary/Renal System and Breasts
Patient presentations span all ages and gender identities, reflecting patients from diverse backgrounds, cultures, and abilities and their reasons for presenting to osteopathic physicians in varied clinical settings.
| 6.1 Anuria, Oliguria, Polyuria, and Edema | |
| 6.2 Enuresis/Incontinence, Prolapse, and Pelvic Relaxation | |
| 6.3 Urinary Frequency/Hesitancy, Nocturia, Urinary Retention, and Dysuria | |
| 6.4 Hematuria, Proteinuria, and Discolored Urine | |
| 6.5 Amenorrhea and Abnormal Uterine Bleeding | |
| 6.6 Urethral Discharge | |
| 6.7 Pelvic Pain | |
| 6.8 Vulvar and Vaginal Discharge, Pruritus, Lesions, and Pain | |
| 6.9 Penile, Scrotal, and Testicular Lesions, Masses, Pain, and Bleeding | |
| 6.10 Pelvic, Prostate, and Renal Masses | |
| 6.11 Breast Masses, Asymmetry, Skin Changes, Discharge, and Pain | |
| 6.12 Physical Exam Findings Related to the Genitourinary/Renal System and Breasts | |
| 6.13 Laboratory and Diagnostic Testing Related to the Genitourinary/Renal System and Breasts |
Clinical presentations in this category may include, but are not limited to, the following conditions or situations prompting patients to present for osteopathic medical care:
| Benign breast disorders | fibroadenoma • fibrocystic disease • galactocele • intraductal papilloma • lipoma • mastitis |
| Benign gynecologic disorders | adenomyosis • endometriosis • leiomyoma • ovarian cyst • ovarian torsion • pelvic adhesions • pelvic inflammatory disease • toxic shock syndrome • vulvovaginitis |
| Benign penile and prostate disorders | benign prostatic hyperplasia • Peyronie disease • phimosis • prostatitis |
| Malignant breast disorders | carcinoma in situ • ductal carcinoma • inflammatory breast cancer • lobular carcinoma • Paget disease of the breast |
| Malignant gynecologic disorders | cervical cancer • endometrial cancer • ovarian cancer • vaginal cancer • vulvar cancer |
| Malignant penile and prostate disorders | penile cancer • prostate cancer |
| Menstrual disorders | amenorrhea (primary and secondary) • anovulatory bleeding • dysmenorrhea • menorrhagia |
| Nephropathy | acute kidney injury • chronic kidney disease • diabetic nephropathy • focal segmental glomerulosclerosis • glomerulonephritis • hypertensive nephropathy • minimal change disease • nephrolithiasis • polycystic kidney disease • tubular necrosis |
| Pelvic organ prolapse | cystocele • enterocele • rectocele • uterine prolapse • vaginal prolapse |
| Sexually transmitted infections | chlamydia • genital herpes • gonorrhea • human papillomavirus • syphilis • trichomoniasis |
| Testicular and scrotal disorders | epididymitis • hydrocele • orchitis • spermatocele • testicular torsion • varicocele |
| Urinary cancers | bladder cancer • kidney cancer • urethral cancer |
| Urinary tract infections | cystitis • painful bladder syndrome (interstitial cystitis) • pyelonephritis • urethritis |
| Urination dysfunctions | congenital outflow tract abnormalities • urinary incontinence (overflow, neurogenic, stress, surge) • urinary obstruction • urine retention |
CONSTITUTIONAL SIGNS AND SYMPTOMS
- anorexia
- chills
- fatigue
- fever
- generalized weakness
- jaundice
- malaise
- night sweats
- unintentional weight loss
PHYSICAL EXAMINATION FINDINGS AND EVALUATION
- abdominal tenderness
- bacteriuria
- breast or genital masses
- bogginess
- cervical motion tenderness
- Chapman reflexes
- costovertebral angle tenderness
- enlargement, tenderness, or masses of the adnexal region
- galactorrhea
- generalized edema
- gross blood
- gynecomastia
- hematochezia/melena
- hematuria
- jaundice
- lesions
- nodules
- pallor
- prostate size or symmetry abnormalities
- pyuria
- rectal tone abnormalities
- skin changes of the breast and genital region
- tender points
- tenderness
- viscerosomatic/
somatovisceral reflexes
LABORATORY AND DIAGNOSTIC TESTING
- antigen testing
- antibody testing
- blood gas analysis
- BUN level
- calcium level
- colposcopy
- CT scanning
- culture and sensitivity of blood, urine, semen, or vaginal discharge
- cystoscopy
- electrolyte panel
- endometrial sampling
- fine-needle aspiration
- Gram staining
- hormone levels
- MRI
- mammography
- microscopy
- nuclear medicine imaging
- Pap smear
- radiography
- renal stone analysis
- serum β-HCG levels
- serum creatinine level
- tumor markers
- ultrasonography
- uric acid level
- urinalysis
- urinary citrate level
- urinary protein level
- vaginal wet mount, KOH prep