Urinary Symptoms

Urinary Symptoms & Causes

Pain

Renal pain: loin/ back pain:  

• Urinary Tract Infections , Pyelonephritis , Urinary Stones 

Cystitis: suprapubic pain: 

• Urinary Tract Infections , Urinary Stones 

Lower urinary tract symptoms: dysuria, frequency, incontinence

• Urinary Tract Infections 

• Urinary Stones 

Haematuria

• Cancer: Renal Cancer , Bladder Cancer, urothelial cancers

• Urinary Tract Infections, Urinary Stones 

• Schistosomiasis: haematobium

• Sickle Cell Disease 

Storage

Incontinence

• • Urge incontinence: detrusor overactivity

  • Stress Incontinence

  • Overflow incontinence: Benign Prostatic Hypertrophy 

Urinary retention: Benign Prostatic Hypertrophy , inabdominal cancer, sepsis

Urine volume

Polyuria

Definition: > 3 litres/ day

• Hyperglycaemia: Diabetes Mellitus, Haemochromatosis, Diabetes Ketotic Acidosis (DKA)

• Renal losses: 

  • Diabetes Insipidus , 

  • Hypoaldosteronism- Adrenal tumour/ Adrenal Insufficiency 

  • Diuretics, caffeine, alcohol

  • Post obstructive diuresis

• Hypercalcaemia: Malignancy, Hyperparathyroidism, 

• Excessive input: Psychogenic polydipisa,  Iatrogenic IVF, 

• Mimics: urinary tract- incontinence: overflow (BPH), detrusor overactivity or stress; retention; urinary tract infection

Oliguria

• Oliguria: < 0.5mg/kg/hr, e.g. < 30ml/hr urine

• Anuria: absence of urine

Causes: AKI

• Pre-renal

• Renal 

• Post renal 

Haematuria

Visible haematuria

Definition: haematuria seen with naked eye (previously called macroscopic)

Concerning for cancer of the urinary tract: bladder, renal or urothelial 

Non visible haematuria

Definition: haematuria on urinanalysis but not visibe with naked eye (previously called microscopic)

NICE Guidelines: indication for cystoscopy

• Over 60yrs old or 

• Leukocytosis

Isolated non visible haematuria doesn't meet two week wait referral for any age, positive predictive value (for UK population) for cancer is < 1%

Resources & References

Written in 2025