Differentials

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

Continuous urine loss with no association to other symptoms or timing.

INVESTIGATIONS

After performing thorough pelvic examination - as well as speculum examination for direct visualization of vaginal pooling and/or fistulous tract - cystoscopy, voiding cystourethrogram, intravenous pyelogram, or retrograde pyelogram may be performed to evaluate and identify location of suspected urogenital fistula.

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

Difficult to differentiate clinically.

Presentation is variable dependent on location of ureteral orifice.

INVESTIGATIONS

Total incontinence due to ectopic ureter or ureterocele may be visualized during physical examination or cystourethroscopy. Intravenous pyelogram can show aberrant anatomy.

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

Frequency and burning with urination. May see hematuria.

INVESTIGATIONS

Urinalysis may show WBCs, red blood cells, nitrites.

Urine culture may be positive.

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

Frequency and irritation with voiding.

INVESTIGATIONS

Shift in mucosal maturation index from superficial cells to a predominance of parabasal cells.

May see increase in vaginal pH.

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

Frequency without irritation. May include incontinence.

Low perceived bladder volume.

INVESTIGATIONS

Urine human chorionic gonadotropin (hCG)-positive.

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

Clinical features of the underlying neurologic condition.

Bulbocavernosus and anal wink reflexes and perineal sensation may be altered.

INVESTIGATIONS

Post-void residual: may be increased.

Urodynamics: may show detrusor overactivity, underactivity, acontractility; bladder outlet obstruction; detrusor sphincter dyssynergia; high urethral resistance.

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