Case 1: Man presents for diabetes review and lower urinary tract symptoms (LUTS)

• Be aware of how to assess a male patient presenting with LUTS
• Be aware of how to perform a prostate examination
• Consider how to obtain consent for intimate examinations
• Reflect on the use of PSA to investigate LUTS
• Consider which members of the MDT are involved in diabetes management.

Lower Urinary Tract Infections - Zero To Finals

Lower urinary tract infections (UTIs) involve infection in the bladder, causing cystitis (inflammation of the bladder). They can spread up to the kidneys and cause pyelonephritis. Urinary tract infections are far more common in women, where the urethra is much shorter, making it easy for bacteria to get into the bladder.

The primary source of bacteria for urinary tract infections is from the faeces. Normal intestinal bacteria, such as E. coli, ******can easily make the short journey to the urethral opening from the anus. Sexual activity is a crucial method for spreading bacteria around the perineum. Incontinence or poor hygiene can also contribute to the development of UTIs.

Urinary catheters are a key source of infection, and catheter-associated urinary tract infections tend to be more significant and challenging to treat.

Presentation

Lower urinary tract infections present with:

• Dysuria (pain, stinging or burning when passing urine)
• Suprapubic pain or discomfort
• Frequency
• Urgency
• Incontinence
• Haematuria
• Cloudy or foul smelling urine