S10.1 Urinary Tract Obstruction

Question 1

How can you differentiate between acute and chronic urinary retention?

Answer 1

Acute is painful and has impaired eGFR

Chronic has urine present on post void residual scan

Question 2

List some causes of acute urinary retention

Answer 2

BPH, prolapse, blood clots, drugs

Question 3

List some neurological causes of urinary retention

Answer 3

Spinal cord injury, detrusor-sphincter dysnergia

Question 4

How do you treat urinary retention?

Answer 4

Catheterisation and monitor fluid balance

Residual volume should be <800ml

Question 5

List some symptoms and risk factors for urinary calculi/stones

Answer 5

Symptoms: pain, haematuria, infection

Risk factors: middle aged, men

Question 6

What causes calculi/stone formation?

Answer 6

Low protein diet

Dehydration

Question 7

What is the most common composition of stones?

Answer 7

Calcium oxalate

Solutes precipitate from urine into crystals

Question 8

What is the treatment for stones?

Answer 8

Stone <4mm can pass in 3 weeks

Can use a stent

Question 9

Describe urosepsis and its cause

Answer 9

Infection of the obstructed system which results in septic urine of the upper urinary tract and kidneys causing infection - pyonephrosis

Other causes: UTI, catheter, prostatitis