FEMALE VAGINAL DYSURIA – DAINS CHAP.

35

Course When did this start? Sudden or Acute, recurring or chronic?

gradual?
Does the pain come and go or is it
steady?
Does it seem to be getting worse with
time?
Triggers? Any thoughts about what,
if anything, caused this?

Aggravating/Alleviatin What, if anything, makes this better?

g: Position/Activity/Rest?
Food/Drinking/Alcohol? If so what?
Meds?
Specific to Dx:

GU: dysuria, frequency, urgency,

nocturia, retention, polyuria,
dribbling/unintended loss, flank pain,
discharge, stones, hx UTI

Pain? Quality, quantity Where? Does the location change over

time?

How long does the pain last? Anything

make the pain better? Worse?

Quality? Dull/sharp? Pressure?

Quantity? # on scale 1-10?
Associated symptoms: General: Fever, body aches, chills,
ROS fatigue, night sweats, muscle
weakness, weight changes
HEENT: Sore throat?
Chart GU here: dysuria, frequency,
urgency, nocturia, retention, polyuria,
dribbling/unintended loss, flank pain,
discharge, stones, hx UTI
Penile discharge, lesions, hx STD,
testicular pain, infertility, ejaculatory
pain, impotence, hernias, last prostate
check?
Contraception?
MSK: joint/muscle pain?
Abdomen: Appetite, n/v,
back/flank/suprapubic pain
Skin: sores/lesions

Related PMH Dysuria: DM? How much spicy

food/caffeine/carbonated
beverages do you drink/eat?
How much water do you drink?
FEMALE VAGINAL DYSURIA – DAINS CHAP. 35

Hold your urine for long periods

of time? Bubble bath, shampoos,
soaps? (Can be irritating)

Menstrual History
• Menarche - age, what early periods
were like
• Typical current menstrual patterns
Regularity, length of cycles
Duration and amount of flow
• Any mittelschmerz, intermenstrual
bleeding/spotting
• Premenstrual symptoms (e.g., tension,
bloating)
• Dysmenorrhea (menstrual cramps)
• LMP date, was it typical. If not
typical, prior nl period

Pap History
• Date last Pap and results
• History of abnormal Paps, treatment,
follow-up
• Any cervical procedures

Perimenopausal History (if indicated)

• Onset of irregularity; change in flow
• Any symptoms (hot flashes, night
sweats, irritability)
• Any postmenopausal bleeding
• Use of any hormones, any side effects
• Attitudes about hormones and
menopause

Pregnancy/Fertility History:
• Gravida, para, abortions (miscarriages
and terminations)
• Number live births, preterm births, and
living children
• Stillbirths
• Any problems with pregnancies-- prenatal,
delivery, postpartum
• Any problems with newborn
• Any difficulty getting pregnant; any
infertility evaluation
• If older than 48, DES exposure in utero

Sexual history:
Sexually active? With how many
partners?
Do you have any new partners?
What gender are your partners?
Satisfaction with current sexual life
 FEMALE VAGINAL DYSURIA – DAINS CHAP. 35

Any sexual difficulties – if any, in what

situations
How protects self from STIs
When was the last time you had
unprotected sex?

Birth control history (if indicated)

• Current method used; how long; any
problems, satisfaction
• Past use - any problems
• Desire for children in future

STD History
History of any STDs including date &
treatment
Do you use condoms? Always,
sometimes,never
Any partner with genital symptoms
Risk exposure to HIV:
Received blood transfusion
IV drug use (patient or partner)
Partner was a prostitute
Paid or received money for sex
Lifetime number of sexual partners

Personal Hygiene
• Any douching or use of feminine hygiene
products
• Use of tampons

Surgical hx:Any procedures or surgeries

involving uterus, ovaries, tubes? When?
Complications?
Related FH Has anyone in your family ever been
diagnosed with cancer? Kidney or
urinary problems?
Related Social History Do you currently work? Where?
Can you tell me a little bit about your
diet?
Do you have any major stressors in your
current life? How do you manage those?
Current meds: What? Frequency? Dosage? Last Prescription:
taken?
Antacids, antibiotics, laxatives?

OTC:

Supplements or herbals:

Allergies What was the reaction?

 FEMALE VAGINAL DYSURIA – DAINS CHAP. 35

Drugs? Environment? Already touched

on food but any missed?
Substances use: Tobacco: how many packs per day
ever? Never? for how long?
Vaping/inhalants:
Alcohol: CAGE- cut down on drinking,
annoyed at others, guilty, eye opener
Recreational drugs:
Effects on daily life How has this affected your life?
& ADLs/Pt’s What do you think caused this?
perception Have you ever had something like this
before?
Close interview: Summarize HPI and
Ask: “Do you have any questions or
other information about what we’ve
covered today?”

Physical exam dysuria:

Note temperature/weight
Inspect general appearance, BMI
Examine mouth
Flank pain/CVA tenderness
Abd palpate and percuss
Inspect perirectal area
Pelvic exam if indicated (suspect vulvovaginitis)