B5-078 Obstructed Ureter Flashcards
symptoms of ureteral obstruction
- flank pain
- groin pain
- vaginal/penile pain
- nausea, vomiting
- fever, chills when infected
- child
- recurrent UTIs
- hydronephrosis but no hydroureter
UPJ obstruction
treatment for UPJ obstruction
pyeloplasty
- 60 year old
- acute onset of severe flank pain
- family hx of renal stones
- dysuria
- fever chills
kidney stone
imaging modality of choice for child with GU symptoms
US
imaging modality of choice for suspected kidney stone
CT without contrast
typical imaging findings of renal stone
hydronephrosis and hydroureter until point where stone is lodged
3 main places stones become lodged
- UPJ
- crossing illiacs
- UVJ
stones only cause pain when they’re
obstructing
(upper ureteral stone)
do calyceal or renal pelvic stones cause pain?
no, not until it enters the ureter and is obstructive
treatment of kidney stones
- medical expulsive therapy (passing)
- ureteral stent (bypasses obstruction only, does not treat stone)
- lithotripsy
- ureteroscopy
if the patient has a kidney stone with signs of infection, should we send them home to pass the stone?
no
risk for sepsis
why should ureteroscopy not be used in a patient will infection?
uses high water pressure, may drive infection further into kidney
stent to drain infection, then go back for ureteroscopy
- 34 year old undergoing chemotherapy for cervical cancer
- low GFR
- asymptomatic
cancer is compressing ureter
extrinsic compression
if unable to pass a stent in a cancer patient, what is another treatment option?
percutaneous nephrostomy tube
