3 Renal outflow Flashcards
What are the different types of urinary tract disease
- urinary tract infection
- urinary tract obstruction (renal stones, tumours, prostatic hypertrophy)
- urinary tract malignancy
Who are most prone to UTIs
- girls (anatomy)
- immunosuppressed
- poor bladder emptying
- low urinary flow rates
what areas do UTIs affect
mostly the bladder but can affect as far as the kidney
what usually causes UTIs
e.coli
staph, fungi, virus and TB possible too
UTIs can cause cystitis what does this mean
bladder inflammation
what does healthy urine consist of
sterile
- i.e. detecting any bacteria implies infection
what type of urine sample should be taken
a mid-stream urine sample (MSSU)- washes out any organisms
what, if found in a mid stream urine sample are indicitive of a problem
- white cells
- blood
- bacteria
whats a sure way to get a sample of urine unaffected with e.g. skin bacteria
suprapubic sterile aspiration
if urine is infected what can this cause
- cystitis
- renal infection
- prostate infection
(urethritis can occur in isolation - gonococcal)
How can a UTI infect the kidneys
via urine reflux
symptoms of UTIs
- dysuria
- urinary frequency
- cloudy urine
- offensive smelling urine
- supra-pubic pain
How do you treat UTIs
- diagnosis!
- increase fluid intake
- frequent micturation
- occasionally antibitics required
what different things can cause urinary tract obstruction
- renal calculi (kidney stones)
- prostatic disease (hypertrophy/prostatic malignancy)
- uriinary tract strictures
- external compression
symptoms of renal calculi
pain as stone goes through ureter
What different types of prostate disease can cause renal obstruction
- prostatis (inflammation of the prostate)
- benign prostatic hypertrophy (hyperplasia of the prostate)
- prostatic cancer (adenocarcinoma)
how can you reduce renal obstruction with someone who has prostatis
little you can do apart from making the urethra wider
how can prostate inflammation lead to infection
bladder has to work harder as urethra squished, can end up with partially emptied bladder, infection
how common is benign prostatic hypertrophy
almost normal for old men (80% over 80 have BPH)
- 100% if they live long enough as prostate keeps growing
syptoms of urine outflow obstruction (BPH)
- slow stream
- hesitancy
- frequency
- urgency
- nocturia
- incomplete voiding
treatment for BPH
- alpha-blocking drugs
- surgery (transurethral or open prostatectomy) n.b. will probably lead to incontanence
- hormone therapy
is prostatic cancer linked to BPH
no, usually happens to one area within the prostate
Why is diagnosis often delayed
- might not affect urination (depends on location of tumour)
- prostatic specific antigen (PSA) test has problems with specificity and sensitivity
- can’t vaccinate as not viral
what is the prostatic specific antigen (PSA) blood test useful for
monitering prostatic malignancy progression
