Session 9- Obstruction and Urolithiasis and Disorders of the Prostate Flashcards
what is the difference between acute an chronic urinary retention
acute- painful
chronic- painless
how can we manage acute urinary retention
catheter record resuidual urinary volume urine dip U&E treat underlying cause
management of chronic urinary retention
catheterise and record residual volume
urine dip
U&E
plan for long term catheterisation ot intermittent self-catherisation
what is the difference between high and low pressure chronic urinary retention
high
- abnormal U&Es
- hypronephrosis
low
- normal renal function
- no hydronephrosus
what is post-obstructive diuresis
following resolution of urinary retention through catheterrisation
kidneys can often over-diurese
can lead to AKI
what is hydronephrosis
dilation of the renal pelvis and calyces due to obstruction at any point in the urinary tract causing increased pressure and blockage
unilateral or bilateral
what causes unilateral hydronephrosis
caused by an upper urinary tract obstruction
what causes bilateral hydronephrosis
caused by obstruction in the lower urinary tract
what is hydronephrosis
obstruction at the pelviureteric junction
what is hydroureter
obstruction at the ureter
what kind of pain do you get in acute ureteric obstrcution
renal colic- from loin to groin
what causes acute ureteric obstrcution
Calculus
blood clots
sloughed papila
what is pyonephrosis
an infected obstructed kidney
drainage of upper urinary tract
nephrostomy
jj stent
what are the majority of urinary calculi
calcium oxalate stones
treatment of renal calculi
adequate analgeisa and high fluid intake
extracorporeal sjock, uretoscopic destrction or removal, PCN;, surgery
what is revealed upon rectal examination
soft
tender
enlarged prostate
main pathogens in acute prostatitis
e coli
proteus and staphylococcus soecies
sexually transmitted pathogens- C. trachomatis and Neisseria gonorrhoeae
what causes chronic prostatitis
results from inadequeately treated infection
how is chronic prostatis diagnosed
histological examination showing neutrophils, plasma cells and lymphocytes
a positive culture from a sample of prostatic secretion
what is BPH
non-neoplasic enlargement of the prostate gland, can eventually lead to bladder outflow obstruction
when do symptoms develop in BPH
as the enlarging prostate gland compeesses on the prostatc urethra
how can untreated BPH present
acute urinary retention
distended and tender bladder
desperate urge to pass urine
urge incontenine
progressive bladder distension
how can we treat BPH surgically
transurethreal resection of protsate
how can we treat BPH mediacally
alpha blockers, reax smooth muscle at bladder neck and within prostate
finasteride- prevents conversion of testosterone into diyhydrotestosterone
