Obstructive Uropathy Flashcards
What does obstructive uropathy mean?
Blockage preventing urine flowing through ureters, bladder and urethra
Leads to back-pressure in urinary system-> proximal site becomes swollen with urine
What are the possible consequences of obstructive uropathy?
Hydronephrosis:
-Swelling of kidney due to distal blockage
Vesicoureteral reflux (VUR) -Urine refluxing from bladder back into ureters
Post-renal AKI
How would an upper urinary tract obstruction present? (Ureters)
Loin to groin or flank pain
-due to stretching and irritation of ureters and kidneys
Reduced/no urine output
Vomiting
Impaired renal function i.e. raised creatinine
How would a lower urinary tract obstruction present?
Bladder/urethra
Poor flow Difficulty initiating urination Terminal dribbling Urinary retention Impaired renal function i.e. raised creatinine
What are the possible causes of upper urinary tract obstruction?
Kidney stones Tumours pressing on ureters Ureter sctrictures Retroperitoneal fibrosis Bladder cancer blocking the ureteral openings Ureterocele
What are the possible causes of lower urinary tract obstruction?
BPH Prostate cancer Bladder cancer blocking the neck of bladder Urethral strictures Neurogenic bladder
What is a neurogenic bladder?
What are possible causes?
What are the consequences?
Abnormal function of nerves innervating the bladder leading to over or underactivity of detrusor muscle
MS Diabetes Stroke PD Brain/SC injury Spina bifida
Urge incontinence
Increased bladder pressure
Obstructive uropathy
What is the management of upper urinary tract obstruction vs lower urinary tract obstruction?
Upper= Nephrostomy
-insertion of thin tube into skin of back into the ureters to enable the urine to drain
What complications can occur due to obstructive uropathy?
Pain
Post-renal AKI
CKD
Infection due to bacteria tracking up UT to areas of stagnant urine
Hydronephrosis
Urinary retention and bladder distention
Overflow incontinence
