Lower urinary tract symptoms (LUTS) template

Issue: Incontinence / UTIs Plan: - Timed incentivised regular voiding - Treat constipation as required (only sometimes firm and difficult to pass) - Footstool to help with bowel motions - Worm treatment - Hygiene advice - Probiotics - High fibre diet with whole foods - Green smoothies – https://www.betterkids.com.au/green-smoothies - Cranberry / D-Mannose Thank you for asking me to see Emily Johnson. Current pattern / habits Emily Johnson admits to passing urine 3 times per day. She finds they are a little wet at times, and doesn't realise when it happens. Sometimes the bowels are a little firm and difficult to pass. Diet She drinks plenty of water during the day, and Mum reports plenty of fibre in the diet. Impact Examination The urinary stream is good, and there is no post void dribbling / incontinence to make me suspicious of labial fusion. I haven't examined specifically for this as it is quite invasive in this age group. Investigations Recent ultrasound results show normal findings with no abnormalities in the kidneys, bladder volume, or post void residual urine. As a surgeon I don't think there is any pathology requiring surgical treatment. We discussed the usual strategies for bladder / bowel optimisation. Another option is to try physiotherapy with biofeedback techniques to help them understand body dynamics further. Thanks again for your referral Dr. Thomas Kelly. Please let me know if I can help further.