Obstructive Voiding

Question 1

In an obstructed setting, the bladder may take time to attain a higher pressure than the urethra to initiate voiding, in this case the patient may describe a DELAY in the INITIATION of micturition AKA:

Answer 1

HESITANCY

Question 2

High resistance in the bladder can result in this patient complaint when they urinate:

Answer 2

DECREASED force of stream

Question 3

2 other common obstructive voiding presenting symptoms:

Answer 3

• Intermittency (interruption in stream)

- Post void dribbling

Question 4

Renal pain in obstructive problems is usually constant or intermittent?

Answer 4

INTERMITTENT

could be constant if infection

Question 5

The site of ureteral pain may help in discerning the location of obstruction. Describe where a patient would have pain if obstruction is upper, mid or low:

Answer 5

Upper ureteral –> scrotum in M, labium in F
Mid ureteral –> lower quadrant (like appendicitis or diverticulitis).
Lower –> inflammation of orifice

Question 6

Which is usually painful, acute or chronic urinary retention?

Answer 6

ACUTE - causes SEVERE suprapubic pain

CHRONIC - painless, with huge vesicle distention

Question 7

T/F. Suprapubic pain while trying to void, or not, can be of vesicle/bladder origin.

Answer 7

FALSE - bladder is usually a result of micturition

Question 8

Patient presents with severe, steady, and radiating pain to the lower abdomen. Also difficulty voiding and on physical exam you feel enlarged kidneys. Kidney ultrasound confirms diagnosis.

Answer 8

Hydronephrosis