Bladder Outflow Obstruction Flashcards
Where may problems arise to cause bladder outflow obstruction in males?
Bladder neck
Posterior urethra
Anterior urethra
Gland penis
Foreskin
Where may problems arise to cause bladder outflow obstruction in females?
Bladder neck
Urethra
Urethral meatus
Vagina
What are the main symptoms associated with bladder outlet obstruction?
Poor flow
Intermittent stream
Spraying/deviated stream
Hesitancy
Post micturation dribbling
What are the main storage-related symptoms associated with outflow obstruction?
Increased frequency of urination
Urgency incontinence
Nocturia
Sense of incomplete emptying
Pain of bladder filling
Which areas will be examined in a male with suspectd bladder outflow obstruction?
Foreskin
Urethral meatus
Glans penis
Penis
Abdomen
PR
Neurological examination
What can cause outflow onstruction associated with the foreskin?
Phimosis
What is a phimosis?
Either a physiological or pathological tightening of the forskin which prevents retraction to reveal the glans penis
What may be examined in the urethral meatus in a male patient with outflow of bbstruction?
Location
Hypospadias
Stenosis
What is hypospadias?
Congenital maformation of the urethra which causes an opening on the underside of the penis
The condition mostly occurs in boys and hypospadia is more common the epispadius (opening on top of penis)
The opening can be either:
- Glanular (least problematic)
- Midshaft
- Penoscrotal
What may be examined for in the penis if there is outflow obstruction?
Palpable stone
Viaible or palpable tumours
Roughness indicating stricture
What is a key abdominal finding for bladder outflow obstruction?
Palpable/percussable bladder
Which findings can be taken from a PR exam that may be relevant to outflow obstrcution?
Anal tone (neurological)
Palpable prostate
Blood (rectal tumour)
What are the main neurological problems which may result in bladder outflow obstruction?
MS
Lumbar disc prolapse
Spinal cord abnormalities
What can be examined for in a vaginal examination for bladder outflow obstruction?
Prolapse
Cysts
Tumours
Atrophy and scarring
Which non-radiological investigations should be undertaken in a suspected bladder outflow obstruction?
FBC
RFTs (urea, creatinine, electrolytes)
Urine dipstick
Urine cultures
Prostate specific antigen
