Bladder Outflow Obstruction Flashcards
Bladder neck causes of obstruction?
- Bladder neck stenosis
- Stone at bladder neck
- Bladder tumour at bladder neck
Urethral causes of bladder obstruction in females?
- Stenosis
- Stone urethra
- Urethral tumour
- Detrusor sphincter dyssynergia (DSS)
Posterior urethral causes of bladder obstruction in males?
- BPH
- Posterior urethral stricture
- Stone in posterior urethra
- Posterior urethral tumour
- Prostate cancer
- Detrusor sphincter dyssynergia
Anterior urethral causes in bladder obstruction in males?
- Urethra strictures
- Obstructing stone
- Urethra cancer
Urethral meatus causes of obstruction in females?
Stenosis
Polyp/tumour
Vaginal causes of obstruction?
Vaginal atrophy
Vaginal prolapse
Vaginal cyst
Glans penis causes of obstruction?
- Urethral meatus stenosis
- Penile cancer
Foreskin causes of obstruction?
Phimosis
Obstruction is more common in which gender?
MALE
All symptoms of bladder obstruction?
- Poor flow
- Intermittent stream
- Spraying of stream/deviated stream
- Hesitancy
- Post micturition dribbling
- Straining
- Frequency of urination
- Urgency
- Urgency incontinence
- Nocturia
- Sens of incomplete emptying
- Pain with bladder filling
- Clots
- Visible haematuria
- Non-visible haematuria
Voiding symptoms of bladder obstruction?
- Poor flow
- Intermittent stream
- Hesitancy
- Spraying of stream/deviated stream
- Post micturition dribbling
- Straining
Storage symptoms of bladder obstruction?
- Frequency of urination
- Urgency
- Urgency incontinence
- Nocturia
- Sense of incomplete emptying
- Pain of bladder emptying
Lab investigation of bladder obstruction?
- Urine dipstick & cultures
- PSA
- FBC
- RFTs (urea, creatinine, electrolytes)
Radiological investigation of bladder?
- X-ray
- US
- TRUS prostate + PVR
- CT KUB (Plain)
- CTU
What is TRUS?
Trans rectal US scan
What is KUB?
Kidneys
Ureter
Bladder
Complications of bladder obstruction?
- Retention of urine
- Detrusor hypofunction
- Recurrent UTI: cystitis, prostatitis
- Bladder stones
- Haematuria
- Incontinence
- Renal failure
General management of bladder obstruction?
Find cause and treat that
Treating prostate (Benign prostatic hyperplasia) caused bladder obstruction?
- Alpha blockers
- 5-Alpha-reductase inhibitors
- TURP/Laser (HoLEP)
Examples of alpha blockers?
- Tamsulosin
- Alfuzosin
What alpha blockers do?
Decreases smooth muscle tone
Examples of 5 alpha-reductase inhibitors?
Finasteride (decrease testosterone)
Treating stricture caused bladder obstruction?
- Optical urethrotomy
- Anastomic urethroplasty
Treating phimosis caused bladder obstruction?
Circumcision
Dorsal slit
Treating urethral stenosis caused bladder obstruction?
Dilation
Treating bladder obstruction caused by bladder stone?
Cystolitholapexy (stone fragmentation)
Tumour treatment when causing bladder ob?
TURBT
Transurethral resection of bladder lesion
