Lower Urinary Tract Symptoms

Question 1

Painless Retention is most likely?

Answer 1

chronic retention

Question 2

Painful Retention is most likely?

Answer 2

acute retention

Question 3

characteristics of obstructive?

Answer 3

Poor Flow
Hesitancy
intermittency
terminal dribbling

Question 4

characteristics of restrictive?

Answer 4

frequency
urgency
nocturia
incontinence

Question 5

why would someone with obstructive also get irritative?

Answer 5

bladder distension

Question 6

what symptom you are least able to control with bladder meds?

Answer 6

nocturia because usually due to circulation

Question 7

cause of strictures?

Answer 7

instruments
radiotherapy
STIs
Trauma/blows
straddle injuries

Question 8

when suspect bladder ca?

Answer 8

smokers and older

irritable bladders

Question 9

What neuro conditions affect bladder?

Answer 9

MS
parkinson’s
strokes
SCI

Question 10

what can epididymitis lead to?

Answer 10

prostatitis

Question 11

during DRE what are you feeling for besides the prostate?

Answer 11

faecal impaction

anal tone

Question 12

if anal tone is down then what?

Answer 12

cauda equina lesion

Question 13

what else to look for in urinary symptoms besides bladder and lower region

Answer 13

kidneys

Question 14

why do you have to urinate more with caffeine?

Answer 14

more bladder contractions

Question 15

why do you have to urinate more with alcohol?

Answer 15

inhibition of ADH

desensitized on bladder distension

Question 16

what causes polydipsia?

Answer 16

DM
lithium
schizo

Question 17

how can sleep apnoea cause nocturia?

Answer 17

waking up gasping for air, increase intra abdominal pressure, more bladder pressure

Question 18

what are alpha blockers used for in urology?

Answer 18

mild lower urinary tract symptoms, relax smooth muscles

Question 19

what are 5-alpha reductase inhibitors used for in urology?

Answer 19

inhibits testosterone to DHT and halts size of prostate

Question 20

what is BNI? when used?

Answer 20

bladder neck incision

used for smaller prostates causing symptoms

Question 21

what’s a clue to clot retention?

Answer 21

haematuria

Question 22

3 reasons why catheter won’t go in:

Answer 22

blocked
no urine due to renal failure
wrong hole

Question 23

what can look like full bladder on U/S in women?

Answer 23

massive ovarian cyst

Question 24

3 things that can cause urinary retention in women:

Answer 24

pelvic masses
carcinoma of cervix
uterine fibroid

Question 25

what does bladder scan tell you? useful when?

Answer 25

volume in bladder

useful in chronic retention

Question 26

what to do before catheterize in painless retention?

Answer 26

scan the kidneys

Question 27

what is obstructive nephropathy?

Answer 27

enough back pressure from retention to cause renal dysfunction

Question 28

how to dx obstructive nephropathy?

Answer 28

elevated creatinine

Bilateral hydronephrosis

Question 29

what is post-obstructive diuresis? why dangerous?

Answer 29

after relieving obstructive nephropathy, you will get copious urine production, may cause arrythmias if lose too much sodium

Question 30

treatment options for obstructive nephropathy?

Answer 30

alpha blockers +

trial of Void

Question 31

what if you fail a trial of void, then what?

Answer 31

surgery unless contraindicated