CHAPTER 1  Evaluation of the Urologic Patient 7

Past Medical/Surgical History

It is essential to obtain a complete medical and surgical history (including prior genitourinary or abdominal surgeries). Obtain operative reports when applicable.

Performance Status

Determine the functional ability of patient as a benchmark for his or her tolerance for undergoing challenging or invasive treatments. Assess a patient’s ability to perform activities of daily living (ADLs), dressing, eating, toileting, hygiene, preparing meals, shopping, maintaining a house, and interactions with family and community. Grading performance status can be completed using the Eastern Cooperative Oncology Group (ECOG) score or Karnofsky performance status.

Medications

Obtain full medication history including urologic medications and anticoagulants. Also consider medications with urologic side effects (Table 1.2).

Social History

Review where the patient lives, who lives at home with patient, and if there are family/friends in the area. Also obtain occupational history to give insight on socioeconomic status and possible industrial exposures. Review sexual history in a non-accusatory manner such as “Do you partake in sexual relations with men, women, or both? A single partner or multiple?” Obtain drug use history including tobacco, alcohol, illicit drug use. This is important for considering withdrawal or difficulty coping during possible procedures/hospitalizations.

Family History

Ask about urologic conditions/diseases/cancers as well as bleeding disorders, reactions to anesthesia and significant non-urologic conditions/disease/cancers.

Review of Systems

Comprehensive system-based checklist related to other symptoms that may or may not be included in HPI or related to CC.

8 CHAPTER 1  Evaluation of the Urologic Patient

Table 1.2  Drugs Associated with Urologic Side Effects