History Taking and Management of a Female Presenting with Dysuria

Areas to focus on: dermatologic (irritant or contact dermatitis, lichen sclerosis, lichen planus, psoriasis, Bechet syndrome), infectious (cystitis, urethritis, pyelonephritis, vulvovaginitis, cervicitis, other sexually transmitted diseases), anatomic (urethral stricture or diverticulum), drug related (spermicides, topical deodorants, opioids, ketamine), endocrine (atrophic vaginitis, endometriosis), idiopathic (interstitial cystitis or bladder pain syndrome), or neoplastic causes (paraurethral leiomyoma, bladder, renal, vaginal, or vulvar cancer).