Editing Urinary Tract Infections (section)

===== History and Physical Exam =====
* '''<span style="color:#ff0000">History'''
** '''<span style="color:#ff0000">Signs and Symptoms'''
***Variable presenting symptoms of cystitis 
***'''<span style="color:#ff0000">Usually include dysuria, frequency, and/or urgency'''
***'''<span style="color:#ff0000">Suprapubic pain, incontinence, hematuria, or foul-smelling urine may develop'''
*** '''In older adults, the symptoms of UTI may be less clear'''
**** Given the subjective nature of these symptoms, '''careful evaluation of their chronicity becomes an important consideration.'''
***** Older females frequently have nonspecific symptoms that may be perceived as a UTI, such as dysuria, cloudy urine, vaginal dryness, vaginal/perineal burning, bladder or pelvic discomfort, urinary frequency and urgency, or urinary incontinence, but these tend to be more chronic
***** '''Acute-onset dysuria, particularly when associated with new or worsening storage symptoms, remains a reliable diagnostic criterion in older females''' living both in the community and in long-term care facilities.
*** '''By definition, acute cystitis is a superficial infection of the bladder mucosa, so <span style="color:#ff0000">fever, chills, and other signs of dissemination are not present.'''
* '''<span style="color:#ff0000">Physical Exam'''
** '''Most have no diagnostic physical findings'''
**'''<span style="color:#ff0000">Abdomen'''
***Some patients may experience suprapubic tenderness
** '''<span style="color:#ff0000">Pelvis'''
***'''<span style="color:#ff0000">Prolapse, urethral tenderness, urethral diverticulum'''
***'''<span style="color:#ff0000">Skene’s gland cyst, or other enlarged or infected vulvar or vaginal cysts'''
***'''<span style="color:#ff0000">Any other infectious and inflammatory conditions (vaginitis, vulvar dermatitis, herpes, and vaginal atrophy</span>''' (genitourinary syndrome of menopause)
***'''Pelvic floor musculature''' for tone, tenderness, and trigger points