Answer 20
It is known that the patient may give his diagnosis
as a gift to his doctor; this can occur on condition that the doctor
pays attention to the history otherwise he may miss this precious
opportunity, and perhaps this what happened with this poor patient, his
doctors have rushed to the investigations and medications which have
been useless, no proof for this more than repetition of the cystoscopy
for more than four times.
Actually we diagnosed this patient but we must
confess that we are indebted firstly to our "Great Lord" then to the
meticulous history which revealed that he was distressed by his
condition which has no cure particularly after finishing all what he had
had, also revealed that the burning is restricted to the urethra and
revealed that the erectile dysfunction is the result not the cause as
believed by some colleagues.
However as we had described before the
"Irritable Vesical or Urinary Bladder Syndrome",
today we are going to describe the "Irritable
Urethral Syndrome" which must be distinguished from:
- Painful Urethral Syndrome: coined firstly by Powell
and Powell in 1949 that is characterized by urinary frequency, dysuria
and suprapubic discomfort without demonstrable infection.
- pudendal neuralgia which may be present by
difficulty in urination, urinary hesitancy, urgency, frequency and
pos-void discomfort.
The last thing I am going to say that our patient
gave a dramatic response by just assurance that nothing threatens his
life in addition to small doses of tricyclic antidepressants.
