Urinary Frequency
Urinary frequency is a genitourinary disorder that presents problems for adults across the lifespan. It can be the result of various systemic disorders such as diabetes, urinary tract infections, enlarged prostates, kidney infections, or prostate cancer. Many of these disorders have very serious implications requiring thorough patient evaluations. When evaluating patients, it is essential to carefully assess the patient’s personal, medical, and family history prior to recommending certain physical exams and diagnostic testing, as sometimes the benefits of these exams do not outweigh the risks. In this Discussion, you examine a case study of a patient presenting with urinary frequency. Based on the provided patient information, how would you diagnose and treat the patient?
Case Study 1
A 52-year-old African American male presents to an urgent care center complaining of urinary frequency and nocturia. The symptoms have been present for several months and have increased in frequency over the past week. He has been unable to sleep because of the need to urinate at least hourly all day and night. He does not have a primary care provider and has not seen a doctor in more than 10 years. His father died when he was a child in an automobile accident, and his mother is 79 years old and has hypertension. The patient has no siblings. His social history includes the following: banker by profession, divorced father of two grown children, non-smoker, and occasionally consumes alcohol on weekends only
To prepare:
• Review Part 13 and 17 of the Buttaro et al. text in this week’s Resources.
• You will either select or be assigned to a patient case study for this Discussion.
• Review the patient case study and reflect on the information provided about the patient.
• Think about the personal, medical, and family history you need to obtain from the patient in the case study. Reflect on what questions you might ask during an evaluation.
• Consider types of physical exams and diagnostics that might be appropriate for evaluation of the patient in the study.
• Reflect on a possible diagnosis for the patient.
• Review the Marroquin article in this week’s Resources. If you suspect prostate cancer, consider whether or not you would recommend a biopsy.
• Think about potential treatment options for the patient.
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In this case study, the patient is a 52-year-old African American male who presents with urinary frequency and nocturia. The symptoms have been present for several months and have increased in frequency over the past week. He has been unable to sleep because of the need to urinate at least hourly all day and night. He does not have a primary care provider and has not seen a doctor in more than 10 years. His father died when he was a child in an automobile accident, and his mother is 79 years old and has hypertension. The patient has no siblings. His social history includes the following: banker by profession, divorced father of two grown children, non-smoker, and occasionally consumes alcohol on weekends only.
Based on the information provided, the following are some possible diagnoses for the patient:
Benign prostatic hyperplasia (BPH): BPH is a condition in which the prostate gland enlarges, putting pressure on the urethra and causing urinary symptoms. BPH is most common in men over the age of 50.
Urinary tract infection (UTI): UTIs are infections of the urinary tract, which can cause urinary frequency, urgency, and pain. UTIs are more common in women than men.
Diabetes: Diabetes can cause a number of urinary symptoms, including urinary frequency, urgency, and incontinence.
Overactive bladder (OAB): OAB is a condition in which the bladder contracts involuntarily, causing a sudden and strong urge to urinate. OAB can be caused by a number of factors, including aging, stress, and medications.
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To confirm a diagnosis, the following tests may be ordered:
Urinalysis: A urinalysis can be used to check for the presence of bacteria, blood, or other abnormalities in the urine.
Prostate-specific antigen (PSA) test: A PSA test is a blood test that can be used to screen for prostate cancer.
Ultrasound: An ultrasound can be used to image the bladder and prostate gland.
Once a diagnosis has been confirmed, treatment can be started. Treatment for BPH may include medications, surgery, or lifestyle changes. Treatment for UTIs may include antibiotics. Treatment for diabetes may include lifestyle changes, medications, or insulin. Treatment for OAB may include medications, lifestyle changes, or surgery.
In this case, I would recommend that the patient see a urologist for further evaluation and treatment. The urologist will be able to order the appropriate tests to confirm a diagnosis and recommend the best course of treatment.