Urethral cancer differential diagnosis: Difference between revisions
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==Differentiation== | ==Differentiation== | ||
[[Urethral cancer|Urethral]] [[cancer]] must be differentiated from the following diseases: | [[Urethral cancer|Urethral]] [[cancer]] must be differentiated from the following diseases: | ||
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* [[Urethritis]] | * [[Urethritis]] | ||
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| doi = 10.1007/s00345-005-0040-4 | | doi = 10.1007/s00345-005-0040-4 | ||
| pmid = 16437219 | | pmid = 16437219 | ||
}}</ref> | }}</ref><ref name="pmid28140610">{{cite journal |vauthors=Kim TH, Kim SY, Moon KC, Lee J, Cho JY, Kim SH |title=Clear Cell Adenocarcinoma of the Urethra in Women: Distinctive MRI Findings for Differentiation From Nonadenocarcinoma and Non-Clear Cell Adenocarcinoma of the Urethra |journal=AJR Am J Roentgenol |volume=208 |issue=4 |pages=805–811 |date=April 2017 |pmid=28140610 |doi=10.2214/AJR.16.16929 |url=}}</ref><ref name="pmid23608423">{{cite journal |vauthors=Cantiello F, Cicione A, Salonia A, Autorino R, Tucci L, Madeo I, Damiano R |title=Periurethral fibrosis secondary to prostatic inflammation causing lower urinary tract symptoms: a prospective cohort study |journal=Urology |volume=81 |issue=5 |pages=1018–23 |date=May 2013 |pmid=23608423 |doi=10.1016/j.urology.2013.01.053 |url=}}</ref> | ||
*The following table summarizes the differential diagnosis for urethritis. | *The following table summarizes the differential diagnosis for urethritis. | ||
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!<small>Urine Culture</small> | !<small>Urine Culture</small> | ||
!<small>Gold Standard | !<small>Gold Standard | ||
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|[[Bladder cancer]] | |||
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|[[Cervical cancer]] | |||
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|[[Bladder stones]] | |||
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|Urethrolithiasis | |||
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|[[Neurogenic bladder]] | |||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Urethritis|'''Urethritis''']] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Urethritis|'''Urethritis''']] | ||
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*Exclusive [[dysuria]] suggest [[Chlamydia]] | *Exclusive [[dysuria]] suggest [[Chlamydia]] | ||
*Painful genital [[ulcers]] with [[dysuria]] suggest [[HSV]] | *Painful genital [[ulcers]] with [[dysuria]] suggest [[HSV]] | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" | [[Cystitis|'''Cystitis''']] | | style="background: #DCDCDC; padding: 5px; text-align: center;" | [[Cystitis|'''Cystitis''']] | ||
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* May accompany [[back pain]], [[nausea]], [[vomiting]], and [[chills]] | * May accompany [[back pain]], [[nausea]], [[vomiting]], and [[chills]] | ||
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*[[Ultrasound]] in patients with [[Testicular pain|acute testicular pain]] to assess for [[testicular torsion]] | *[[Ultrasound]] in patients with [[Testicular pain|acute testicular pain]] to assess for [[testicular torsion]] | ||
*If equivocal do surgical exploration | *If equivocal do surgical exploration | ||
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Revision as of 14:38, 9 January 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2]
Overview
Urethral cancer must be differentiated from bladder cancer, cervical cancer, bladder stones, ureteral stones, cystitis, neurogenic bladder, and urethritis.
Differentiation
Urethral cancer must be differentiated from the following diseases:
DDx for Urethritis:
Urethritis must be differentiated from other diseases that cause lower urinary tract irritation symptoms (e.g., dysuria, urgency and frequency in addition to urethral discharge); these include cystitis, cervicitis, vulvovaginitis, epididymitis, prostatitis, and syphilis.[1][2][3][4][5][6][7][8][9][10][11]
- The following table summarizes the differential diagnosis for urethritis.
| Diseases | Symptoms | Physical Examination | Diagnostic tests | Past medical history | Other Findings | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Hematuria | Pyuria | Frequency | Urgency | Dysuria | Fever | Tenderness | Discharge | Inguinal Lymphadenopathy | Urinalysis | Urine Culture | Gold Standard | |||
| Bladder cancer | ||||||||||||||
| Cervical cancer | ||||||||||||||
| Bladder stones | ||||||||||||||
| Urethrolithiasis | ||||||||||||||
| Neurogenic bladder | ||||||||||||||
| Urethritis | – | + | – | – | + | + | – | Urethral discharge | + |
|
– | Gram stain & mucoid or purulent discharge |
|
|
| Cystitis | + | + | + | + | + | + | Suprapubic | – | + |
|
>100,000CFU/mL | Urine culture |
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| Diseases | Symptoms | Physical Examination | Diagnostic tests | Past medical history | Other Findings | |||||||||
| Hematuria | Pyuria | Frequency | Urgency | Dysuria | Fever | Tenderness | Discharge | Inguinal Lymphadenopathy | Urinalysis | Urine Culture | Gold Standard | |||
| Vulvovagintis | – | – | – | – | + | + | – | Vaginal discharge | + | – | – | Gram stain & culture of discharge |
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| Cervicitis | – | + | – | – | + | + | Cervical | Endocervical exudate | – | – | – | Culture for gonococcal cervicitis |
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| Epididymitis | + | – | + | + | + | + | Testicular & suprapubic | +/– urethral discharge | + |
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+ | Culture |
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References
- ↑ Stephen Bent, Brahmajee K. Nallamothu, David L. Simel, Stephan D. Fihn & Sanjay Saint (2002). "Does this woman have an acute uncomplicated urinary tract infection?". JAMA. 287 (20): 2701–2710. PMID 12020306. Unknown parameter
|month=ignored (help) - ↑ W. E. Stamm (1981). "Etiology and management of the acute urethral syndrome". Sexually transmitted diseases. 8 (3): 235–238. PMID 7292216. Unknown parameter
|month=ignored (help) - ↑ W. E. Stamm, K. F. Wagner, R. Amsel, E. R. Alexander, M. Turck, G. W. Counts & K. K. Holmes (1980). "Causes of the acute urethral syndrome in women". The New England journal of medicine. 303 (8): 409–415. doi:10.1056/NEJM198008213030801. PMID 6993946. Unknown parameter
|month=ignored (help) - ↑ Leonie G. M. Giesen, Grainne Cousins, Borislav D. Dimitrov, Floris A. van de Laar & Tom Fahey (2010). "Predicting acute uncomplicated urinary tract infection in women: a systematic review of the diagnostic accuracy of symptoms and signs". BMC family practice. 11: 78. doi:10.1186/1471-2296-11-78. PMID 20969801.
- ↑ Taylor-Robinson D (1996). "The history of nongonococcal urethritis. Thomas Parran Award Lecture". Sex Transm Dis. 23 (1): 86–91. PMID 8801649.
- ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 9781455748013.
- ↑ Brill JR (2010). "Diagnosis and treatment of urethritis in men". Am Fam Physician. 81 (7): 873–8. PMID 20353145.
- ↑ Daniel V. Landers, Harold C. Wiesenfeld, R. Phillip Heine, Marijane A. Krohn & Sharon L. Hillier (2004). "Predictive value of the clinical diagnosis of lower genital tract infection in women". American journal of obstetrics and gynecology. 190 (4): 1004–1010. doi:10.1016/j.ajog.2004.02.015. PMID 15118630. Unknown parameter
|month=ignored (help) - ↑ Felix Millan-Rodriguez, J. Palou, Anna Bujons-Tur, Mireia Musquera-Felip, Carlota Sevilla-Cecilia, Marc Serrallach-Orejas, Carlos Baez-Angles & Humberto Villavicencio-Mavrich (2006). "Acute bacterial prostatitis: two different sub-categories according to a previous manipulation of the lower urinary tract". World journal of urology. 24 (1): 45–50. doi:10.1007/s00345-005-0040-4. PMID 16437219. Unknown parameter
|month=ignored (help) - ↑ Kim TH, Kim SY, Moon KC, Lee J, Cho JY, Kim SH (April 2017). "Clear Cell Adenocarcinoma of the Urethra in Women: Distinctive MRI Findings for Differentiation From Nonadenocarcinoma and Non-Clear Cell Adenocarcinoma of the Urethra". AJR Am J Roentgenol. 208 (4): 805–811. doi:10.2214/AJR.16.16929. PMID 28140610.
- ↑ Cantiello F, Cicione A, Salonia A, Autorino R, Tucci L, Madeo I, Damiano R (May 2013). "Periurethral fibrosis secondary to prostatic inflammation causing lower urinary tract symptoms: a prospective cohort study". Urology. 81 (5): 1018–23. doi:10.1016/j.urology.2013.01.053. PMID 23608423.