Genitourinary Disorders

Genitourinary disorders are diseases experienced when the genital and urinary organs function improperly. In most cases, such disorders are associated with injury, illnesses, and aging. The genitourinary disorders appear in different forms including interstitial cystitis, urinary incontinence, kidney stones, neurogenic bladder, urinary tract infection, prolapsed uterus, and pelvic inflammatory disease. Apart from these disorders causing urinary problems, they can also affect an individual’s reproductive systems. The genitourinary illnesses are life-altering as they affect the quality of life.

Differential Diagnosis

Diagnoses are meant to help physicians to detect and act on the disease, however, some diagnoses cause flank pains including trauma, pyelonephritis, and urinary tract infections.

•         Pyelonephritis is a diagnosis that has been found common with preschool children. This disease is flanked by pain and other febrile diseases, such as emotional stress, chronic recurrent abdominal pain, early appendicitis, and gastrointestinal syndromes (Santos, Lopes, & Koyle, 2017).
•         Urinary tract infection (UTI) is a common urinary infection. Diagnosis is based on the accurate urine culture findings which reveal that the individuals with the disease experience bad smelling urine or looking reddish or cloudy (Nelson, 2016). The patient always feels an urge to urinate, as well as feeling pain during urination. The individual with UTIs would experience pain in the back, tiredness, fever, or shakiness.
•         Intersex abnormalities which involve physical examination to help determine the anatomical classification (Burns, 2013). This is evident when the syndrome is associated with cryptorchidism.

Primary diagnosis and rational

The initial evaluation of patient’s conditions will involve physical and clinical history examination. Bowel and voiding diaries will offer relevant and reliable information about the condition of the patients (Santos et al., 2017). The diary should be based on a 48-72-hour reading; therefore, the records of patient’s urine volumes can be estimated in terms of the maximum voided volumes. With the help the Bristol stool chart, it is possible to monitor and diagnose constipation treatment response, especially for children with balder bowel dysfunction.

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Orders to address the issues

Based on the urgency to address this syndrome, I will give orders covering behavioral, pharmacological, and surgical treatment plans.

Behavioral orders

Parents, caregivers, and children must be educated on urotherapy because this is the only non-surgical and non-pharmacological treatment method available (Burns, 2013). The orders will encompass:

•         Caregivers and parents must ensure adequate hydration
•         Conduct pelvic floor muscle awareness
•         Undertake timed avoiding
•         Conduct bowl regiment through stool softeners, optimal hydration, and high intake of dietary fibers

The urotherapy will maximize contraction and relaxation of muscles.

Pharmacological orders

When the urotherapy fails to yield expected outcomes, pharmacological treatment should be the second option. Patients with chronic conditions need long-term treatments using different anticholinergics (Santos et al., 2017). The adult patients should use any of these anticholinergics depending on the physician’s prescriptions:

•         Oxybutynin
•         Trospium
•         Tolterodine

Surgical treatment

In a situation where a patient has experienced the disorder for over nine months, it would be prudent to recommend surgical treatments including:

•         Refractory detrusor overactivity: In children, sacral transcutaneous stimulation is advisable because it lacks negative side effects, especially in children with symptom severity and bowel bladder dysfunctions (Santos et al., 2017).
•         If the maximum medical therapies, such as enema therapies, medications, and diet fail, an antegrade continence enema procedure should be considered (Santos et al., 2017). This will help to handle cases of intractable defecation disorders.

These orders, however, should only guide the patient, physician, and families in making ind