Urological patients may have symptoms that affect both the kidneys and other parts of the urogenital tract. A history is usually projected in the edge or the lower back of the kidneys and ureters outgoing pain and can radiate into the equilateral bar, thighs, testicles or labia. Is the pain caused by an infection, they are more consistent. Pain caused by calculi are colicky and may be devastating. A below the bladder induced urinary retention causes agonizing suprapubic pain. Chronic urinary retention causes less pain and can be asymptomatic. Dysuria is a symptom of bladder and urethral irritation (dysuria). emanating from the prostate pain manifest in diffuse discomfort or pressure in the perineal, rectal or suprapubic area. In men, the symptoms of bladder obstruction include a delayed Miktionsbeginn a difficult urination, weakening of the urinary stream and dribbling. Incontinence can have different shapes (urinary incontinence in adults). A bedwetting after the 3rd-4th Age may be in girls symptom of urethral stenosis or boys of rear urethral valves. The enuresis may occur as a sign of psychological pressure or new to infections. Pneumaturia (air in the urine is excreted) suggests a vesicovaginal, vesikoenterale ureteroenterale or fistula. The latter two can be caused by diverticulitis, Crohn’s disease, an abscess or colon carcinoma. A pneumaturia could also be due to a emphysematous pyelonephritis. Physical Examination Physical examination focuses on the costovertebral angle, abdomen, rectum, moldings and genitals. In women with urogenital complaints usually a gynecological examination is performed. Kostovertebraler angle pain caused by an obtuse blow on the back, the flanks, or the angle between the 12th rib and spine (kostovertebraler pressure – / knock pain) may be triggered speak for pyelonephritis, stone or Harntraktobstruktion.Abdomen provides a visible bulge in the upper abdomen an extremely rare and non-specific finding in hydronephrosis or mass of the kidneys or the abdomen. an attenuated percussion sound in the lower abdomen suggests a bladder over-elongation. Normally a full bladder itself can not be knocked over the symphysis pubis. The scanning of the bladder, a Blasendistension or urinary retention bestätigen.Rektum In digital rectal examination prostatitis can be felt as a swampy, soft prostate. Focal node and hard areas need to be distinguished from a prostate cancer. The prostate is enlarged symmetrically, rubbery and not be painful, with benign Prostatahyperplasie.Leisten and genitals The inuginale and genital examination should be carried out with the patient standing. A Inuginalhernie or adenopathy may be the explanation for pain in the scrotal or genital area. A massive asymmetry, swelling, redness or discoloration of the testicles can be a sign of an infection, torsion, to a tumor or other lesions. A horizontal position of the testicles ( “bell-clapper deformity”) shows an increased risk for torsion. If a testicular higher (normally the left lower), this may be a sign of torsion. The penis is examined with and without retracting the foreskin. Through an examination of the penis following can be detected: hypospadias or epispadias in boys Peyronie’s disease in men priapism, ulcers and discharge in both groups. By palpation a Inuginalhernie can be detected. The cremasteric may be absent at a testicular torsion. The localization of the masses in relation to the testicles, and the degree and localization of the sensitivity can help between the testicular masses (z. B. Spermatocele, epididymitis, hydrocele, tumors) to be distinguished. If swelling is present, the area should be shown by ultrasound to see if the swelling is cystic or solid. Fibrous plaques on the penile shaft are signs of Peyronie’s disease (Peyronie’s disease). Urinalysis tests (study of nephrology patients: urinalysis) is for assessing urological disorders is of paramount importance. imaging techniques (e.g., as ultrasound, CT, MRI) are often required. Semen evaluation, sperm disorders. The bladder tumor antigen investigation feels the transitional cell urinary tract more sensitive than urine cytology for low-grade carcinomas. but it is not sensitive enough to replace cystoscopy. The urine cytology is the best study on the discovery of high-grade carcinomas. Prostate specific antigen (PSA) is a glycoprotein produced by prostatic epithelial cells. The mirror can be increased (eg. As benign prostatic hyperplasia, infection, trauma) in prostate cancer, but also in other general nichtkarzinomatösen changes. The PSA test is used to detect recurrence after treatment. The widespread use for cancer screening is controversial (prostate cancer: screening process).