Chapter 3 · General principles
Acute pain in urology: differential diagnosis
Definition
The priority is to address causes that cannot be managed conservatively: infected obstruction, significant bleeding, organ ischemia, urinary tract rupture, and progressive organ dysfunction.
Clinical assessment
As in Chapters 1–2, with emphasis on the site, radiation, and progression of pain and associated symptoms (nausea, vomiting, dysuria, hematuria).
Danger signs
(See Section 1.3.)
Diagnosis
(See Section 1.4.)
Emergency management
- ABCDE → pain control and monitoring of vital signs → identify reversible causes.
- Infection + obstruction → urgent drainage.
Algorithm
| Step | Action |
|---|---|
| 1 | Rule out threats to life/organ function |
| 2 | Stabilize the patient |
| 3 | Establish urinary drainage in obstruction |
| 4 | Obtain microbiological samples before antibiotics |
| 5 | Start empirical antibiotic therapy |
| 6 | De-escalate once results are available |