Lower Urinary Tract Problems

1. Ms. Lucy, A 55 year old woman developed stage 2 cervical cancer, 6 months earlier and was treated with combined chemotherapy and radiotherapy. She now complains of blood in her urine which occurs all the time. What is the next best investigation for her which helps in management of this patient?

2. Ms. Rica, A 35 year old woman attends the emergency gynaecology clinic with recurrent episode of urinary retention. She has been treated in the past for endometriosis. She has been investigated for the same 
Ultrasound and C scan of abdomen and pelvis are normal 
Urodynamic study – shows large capacity bladder without the usual sensations during the filling phase and Detrusor s under activity is noted. Urethral pressure flow metry has shown  – The maximum urethral closure pressure is typically found to have resting values in 102 cm water. You are thinking of diagnosis Of Fowler syndrome. Which test is diagnostic to confirms diagnosis?

3. Ms, sweetie, 32 year old, is unable to void and present with painless urinary retention. On evaluation, post‐void residual volumes in excess of 1 litre. She  experience pain at times but do not report the expected urgency, which is surprising at such a large bladder capacity.  Her Straining at toilet is not helping to empty the bladder and she feels sh3 must promote sphincter relaxation to void by whatever means she can. She also gives history of polycystic ovaries. What is your probable diagnosis?

4. Ms. Della, 65 year old had a difficult hysterectomy 6weeks back, she complains of being wet all the time. On clinical examination   She is afebrile, speculum examination showed some clear fluid vault is healthy. Three swab test showed a swab wet but not with dye. What is your Probable diagnosis