Evaluación clínica del paciente con síntomas del tracto urinario inferior

Abstract

Lower urinary tract symptoms are divided into three groups, storage, voiding and post
 micturition symptoms. Their level of agreement with urodynamic investigation is poor. Clinical
 history should be complemented by the application of validated symptom questionnaires
 and the recording of urinary events. Here we refer to: a) the International Consultation on
 Incontinence Questionnaire, Short Form (ICIQ-SF), b) the Urogenital Distress Inventory - Short
 Form (UDI-6) and Incontinence Impact Questionnaire – Short Form (IIQ-7), c) the urinary
 incontinence Severity Index and d) the American Urological Association Symptom Index. The
 recordings of urinary events can be done in three main forms: a) micturition time chart, b)
 frequency volume chart, and c) bladder diary. The International Consultation on Incontinence
 Questionnaire bladder diary (ICIQ bladder diary) is the only one validated. Physical exam should
 include abdominal and genital examination, covering pelvic organ prolapse quantification in
 women, prostate evaluation in men, pelvic floor muscle function evaluation in both genders, and
 a neurologic examination focused on evaluation of the sacral nerves. It is useful to supplement
 the physical examination with the evaluation of the mobility of the bladder neck and proximal
 urethra through the Q-tip test, and with the quantification of urine leakage through the pad test