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
