9.1.1 Obstruction Flashcards
list some causes of urinary retention
-calculi
-pregnancy
-BPH
-recent surgery
-urethral strictures
-constipation
-tumours
-neurogenic disorders of micturition
how can pregnancy cause urinary retention?
high levels of progesterone relax smooth muscle in renal pelvis and ureters = easier to obstruct
risks of not treating acute urinary retention quickly
AKI (if post renal obstrcution)
hydronephrosis
common U&E deranged result in chronic urine retention
K+
would you attempt TWOC in chronic kidney obstrcution?
no
explain how relieving an obstruction could cause post-obstructive diuresis
relieve obstruction, kidneys allow too much fluid loss so lose corticopapillary gradient, now cant absorb enough water
so can cause/worsen pre renal AKI
what to do in post-obstructive diuresis
monitor for 24 after catheter
IV fluids if high urine volume
define hydronephrosis
dilation fo renal pelvis and calyces due to obstruction ij urinary tract causing increased pressure and blockage
explain the effect hydronephrosis has on GFR
reduces, as Pbc now bigger so counteracts Pgc
sloughed papilla
renal pyramid falls into papilla collecting system, urine cant flow out
causing acute ureteric obstruction
treatment of pyronephrosis
emergency decompression by removing obstruction
how to diagnose urinary tract obstruction
CT/US but won’t show fucntion
diuretic retinography- radioactive trace taken up by kidneys, then give diuretic to flush out
3 most common sites for urolithiasis
- pelviureteric junction
- pelvic brim
- vesicoureteric junction
diagnosis of urolithiasis
CT kidney ureter bladder
presentation of renal stones
continuous dull ache in loin
