Obstructive uropathy Flashcards
What is obstructive uropathy?
An obstruction that prevents urine flow through the ureters, bladder and urethra.
What are some complications of obstructive uropathy?
Pain AKI (post renal) Chronic kidney disease Infection (due to stagnant urine) Hydronephrosis Urinary retention + bladder distention Overflow incontinence
What is hydronephrosis?
Swelling of the kidney
What is vesicoureteral reflux?
When urine refluxes from the bladder back into the ureters
How does an upper urinary tract obstruction (ureters) present?
Loin to groin (flank) pain on affected side
Reduced or no urine output
Non specific systemic symptoms - e.g. vomiting
Impaired renal function - on blood tests
How does a lower urinary tract obstruction present?
Difficulty or inability to pass urine (voiding LUTS - poor flow , dribbling etc.)
Urinary retention - distended bladder
Impaired renal function on bloods - e.g. creatinine
What are some common causes of upper urinary tract obstruction?
Kidney stones Tumours Ureteric strictures Bladder cancer (blocking ureteral openings) Retroperitoneal fibrosis
What are some common causes of lower urinary tract obstruction?
BPH Prostate cancer Bladder cancer (neck) Urethral strictures Neurogenic bladder
What is neurogenic bladder?
When there is abnormal function of the nerves that innervate the bladder. This can cause under or overactivity of the detrusor muscle and the urethral spincters.
What are the common causes of neurogenic bladder?
Multiple sclerosis Diabetes Stroke Parkinsons Brain / spinal cord injury Spina bifida
What problems can be caused by neurogenic bladder?
Urge incontinence
Increased bladder pressure
Obstructive uropathy
How is obstructive uropathy managed?
Removal or bypass of the obstruction
For temporary relief of retention
- nephrostomy
- urethral or suprapubic catheter
