Urinary Tract Obstruction Flashcards
symptoms of upper urinary tract obstruction
dull, sharp or colicky flank pain (intermittent or persistant)
nausea and vomiting
anuria (if bilateral)
haematuria
signs of upper urinary tract obstruction
palpable mass, microscopic haematuria, complication signs
complications of upper urinary tract obstruction
infection, sepsis and renal failure
sites of obstruction in upper tract
pelvic ureter junction
ureter
vesico-ureter junction
sites of obstruction in lower tract
bladder neck prostate urethra urethral meatus foreskin
what type of tumour would occur in the upper tract to cause obstruction
a transitional cell carcinoma
what is the most common renal cancer
clear cell carcinoma
causes of obstruction in all parts of upper tract
stone and tumour
causes of obstruction only in PUJ and ureter
blood clot and fungal ball
things that might cause obstruction from outside the upper tract
lymph nodes
abdominal mass
prostate tumour
investigations for upper tract obstruction
dipstick renal ultrasound urea and creatinine WBC non-contrast CT (pyelogram) PSA
risk factors for urinary tract obstruction
BPH constipation urolithiasis spinal cord injury malignancy meatal stenosis
emergency treatment of upper obstruction
percutaenous nephrostomy insertion
OR
retrograde stent insertion
what is a percutaneous nephrostomy insertion
a small flexible tube inserted into kidney to drain urine. can also be to remove kidney stones
effect of retrograde stent on ureter
dilates it because ureter doesn’t like plastic
where does a retrograde stent go
in the ureter
presentation of lower tract obstruction
LUTS acute/chronic urinary retention recurrent UTIs frank haematuria bladder stones renal failure
sign in urine of lower or upper tract obstruction
haematuria (frank or microscopic)
what kind of urinary retention does lower tract obstruction present with
acute or chronic
effect of urinary retention on abdomen
abdomen bulges at bladder
emergency treatment of lower tract obstruction
urethral or suprapubic catheterisation
imaging in lower tract obstruction
bladder scan, renal tract ultrasound
decompression haematuria
small vessels shear in presssure change
