Renal Outflow Obstruction (and infection) Flashcards
What microorganism is associated with urinary tract infections?
E.coli
Who is commonly affected by UTI’s?
Females - due to the anatomy
What are predisposing factors to UTI’s?
Low urinary outflow
Poor bladder emptying
Urine should be sterile; what could be found in urine that would imply that there will be further problems?
White blood cells
Blood
How can urine be sampled?
Mid stream sample:
Allows the microorganisms residing in the urethra to be washed away before the sample is taken.
Also allows the sample to be taken before the microorganism start to reenter the urethra after urination.
Supra-pubic sample
Which urine sampling technique is least likely to encounter contamination?
Supra-pubic sampling
What can infected urine lead to?
Cystitis
Kidney infection - from reflux of infected urine.
Prostate infection
What is urethritis caused by?
Gonococcal infection
STI
What are the symptoms of a UTI?
Dysuria Cloudy urine Change in frequency of urination Foul smelling urine Supra-pubic pain
How is a UTI treated?
Increasing fluid intake
Increasing urination
Antibiotics: if infection is causing systemic symptoms e.g. raised temperature take amoxycillin.
What can cause urinary tract obstruction?
Renal calculi
External compression
Prostatic disease
Urinary tract strictures - scarring that causes narrowing.
What are renal calculi and how do they cause pain ?
Stones that form in the kidney and move to the bladder.
Pain arrises when the stones get stuck in the ureter and peristalsis, spasms and contractions occur around the trapped stone.
List the types of prostatic disease.
Prostatitis
Benign prostatic hypertrophy
prostatic cancer
What is prostatitis? How is this problematic?
Causes sudden narrowing of the urethra due to inflammation of the prostate surrounding it.
What further problems can prostatitis cause?
Can cause cystitis - bladder will have to contract harder to void the urine since the urethra is narrowed, the high pressure required to void urine is difficult to maintain = partial emptying of the bladder = inflammation.
What is benign prostatic hypertrophy?
The continuous growth of the prostate over many years (like nose and ears) can cause narrowing of the ureter or even complete blockage.
This will occur in 100% of men if they live long enough.
What are the symptoms of benign prostatic hypertrophy?
Hesitation
Slow stream
Incomplete voiding = cystitis
Nocturia
How do you treat benign prostatic hypertrophy?
Initially treated with drugs - alpha blockers - to shrink the prostate.
Surgery:
TURP: Transurethral prostectomy - trim away some of the prostate to relieve narrowing.
Open prostectomy - complete removal.
Can lead to incontinence - most likely a last resort.
What time of carcinoma affects the prostate?
Adenocarcinoma
How does prostate cancer present?
Presents late on as difficulty passing urine due to compression of the urethra.
Where does prostate cancer typically metastasise to?
Bone
What test is used to monitor prostate cancer?
Why can’t this be used for screening?
Prostatic Specific Antigen blood test
Is inaccurate (false positives given and sometimes doesn’t detect the antigens)
How is prostatic cancer treated?
Radiotherapy
Surgery - radical prostectomy.
Hormone treatment to blocks specific hormones - glandular cancers are associated with the levels of some hormones.
