Renal Outflow Disease Flashcards
What are the different types of urinary tract diseases
Urinary tract infection
Urinary tract obstruction - renal stones, tumours and prostatic hypertrophy
Urinary tract malignancy
How can urine samples indicate a urinary tract disease
Sterile - detecting any bacteria implies infection Skin contamination possible White cells in urine Blood in urine (microscopic only) Collect MID-stream urine sample (MSSU)
Describe the causes of urinary tract infections
Common in women than men Usually E.coli (85%) Staph, fungi, virus and TB also possible Cystitis is bladder inflammation Predisposing factors - poor bladder emptying and low urinary flow rates
What are the symptoms of UTIs
Dysuria Urinary frequency Cloudy urine Offensive smelling urine Supra-pubic pain
What can infected urine cause
Cystitis
Renal infection
Prostate infection
Urethritis can occur in isolation - gonococcal
What are the treatments for UTIs
Diagnosis - MSSU only, microscopy, culture and sensitivity
Increase fluid intake
Frequent micturation
Occasionally antibiotics required - trimethoprim, amoxicillin
What are common causes of urinary tract obstruction
Renal calculi
Prostatic disease -hypertrophy or malignancy
Urinary tract strictures
External compression
Give examples of prostate disease
Prostatitis- inflammation of the prostate
Benign prostatic hypertrophy - hyperplasia of the prostate
Prostatic cancer - adenocarcinoma
Who is more likely to get benign prostatic hypertrophy
Almost a normal thing
80% of men over age 80 have BPH
100% if they live long enough
What are the symptoms of benign prostatic hypertrophy
Symptoms of urine outflow obstruction Slow stream Hesitancy Frequency Urgency Nocturnal Incomplete voiding
How is benign prostatic hypertrophy treated
Initially drug based - a-blocking drugs, anti Cholinergic, diuretics Surgery - prostatectomy TURP - transurethral prostatectomy Robot-assisted prostatectomy (RALP) Open prostatectomy
Who is most likely to have a prostatic malignancy
Starts after age 45 90% of men >90 years have this at autopsy Most asymptomatic - not cause of death 10% of men have symptomatic disease 2nd commonest male cancer in the USA 89% 5 year survival 63% 10 year survival
Describe prostate cancer screening
PSA blood test not always diagnostic
Prostatic specific antigens
Useful for monitoring disease activity in those known to have the disease
mpMRI - now recommended for early detection of prostate cancer
What are the treatments for prostatic malignancy
Surgery - radical prostatectomy
Radiotherapy
Hormone treatment - anti-androgens and LHRH analogues, block hormone dependant tumour growth
What is a common side effect of prostatic malignancy
Widespread bone metastasis - osteosclerosis
