1. Urinary History Haddy Cosh and Amy Wood

2. PC / HPC - Symptoms BLADDER Incontinence Frequency (discuss normal) Urgency Pain – renal colic, suprapubic, loin Nocturia (sign of enlarged prostate) Terminal Dribbling Incomplete voiding – Does it feel empty when you’ve been? PROSTATE Flow – Stop / Start? Hesitancy Terminal Dribbling Haematuria PENIS Discharge (tell me about it) Smelly Itchy Blisters Warts

3. Red Flags Bone Pain Back pain Weight Loss Appetite loss Night sweats Haematuria = Prostate Cancer unless proven otherwise Associated symptoms Fever Confusion Rigors Sores

4. Sexual History How do you introduce the concept? Do you mind if I ask you some personal questions? I have to ask everyone who comes in with your symptoms.. Are you sexually active? (If not, ask “do you mind if I ask why”.. Impotence) Ask about the 5 P’s: Partners Practices Protections Past history (Pregnancy)

5. Partners: Do you have a regular partner? (Don’t assume M/F) How many partners in the last 5 Years? Is the partner experiencing any symptoms? Practices: What sort of sex is it? Protection: Do you use protection? Clarify how!! Past history: Have you ever had a Sexually Transmitted Infection / visited a GUM clinic? Have you ever paid someone for sex?

6. PMH Recent hospital visits- catheter? Diabetes (impotence & increased risk of infection) Hypertension Trauma MS

7. DH Oxybutynin (Antimuscarininc reduces urgency and incontinence) Diuretics Digoxin (Renal excretion -dose dependent on renal function) Lithium (Renal excretion) Opioids (effects on excretion of water and sodium) B – blockers (Renal excretion) ACE inhibitors (Cause increased renal blood flow and promote salt excretion) NSAIDs (Renal Excretion) + Allergies

8. Finishing off the history FH Kidney disease Diabetes SH Factory worker? Paid for sex? Abroad (Schistomasis) Smoking / Alcohol Systems Review