Editing AUA & CUA Recurrent UTI (2019) (section)

===== History and Physical Exam =====
* '''<span style="color:#ff0000">History'''
** '''Characterize current LUTS''' (dysuria, frequency, urgency, nocturia, incontinence, hematuria, pneumaturia, fecaluria)
***'''Characterize baseline symptoms between infections'''
**Back or flank pain; catheter usage; vaginal discharge or irritation
**'''UTI history''': frequency of UTI, antimicrobial usage, and documentation of positive cultures and the type of cultured microorganisms, responses to treatment for each episode, the symptoms the patient considers indicative of a UTI, the relationship of acute episode to infectious triggers (e.g. sexual intercourse for post-coital UTIs), relationship of infections to hormonal influences (e.g., menstruation, menopause, exogenous hormone use), results of any prior diagnostic investigations
**'''Bowel symptoms''' such as diarrhea, accidental bowel leakage, or constipation
** '''Menopausal status; contraceptive method; and use of spermicides or estrogen- or progesterone-containing products'''
** '''Risk factors for complicated UTI (see [[Urinary Tract Infections|Urinary Tract Infections Chapter Notes]])'''
** '''Medications''' (immunosuppressive meds, recent use of antibiotics for any medical condition), '''PMHx, PSHx''' (may suggest complicated UTI), '''allergies, travel history'''
* '''<span style="color:#ff0000">Physical Exam'''
** '''<span style="color:#ff0000">Abdominal and pelvic examination'''
***'''Prolapse, urethral tenderness, urethral diverticulum, Skene’s gland cyst, or other enlarged or infected vulvar or vaginal cysts'''
***'''Any other infectious and inflammatory conditions (vaginitis, vulvar dermatitis, and vaginal atrophy''' (genitourinary syndrome of menopause)
***'''Pelvic floor musculature''' for tone, tenderness, and trigger points
** '''Focused neurological exam''' 
***'''May also be considered''' to rule out occult neurologic defects