Urinary tract Obstruction Flashcards
What are some symptoms associated with urinary tract obstruction?
Pain
Frank haematuria
What are some signs associated with UT obstruction?
Palpable mass
Microscopic haematuria
What are some complications of UT obstruction?
Infection
Sepsis
Renal failure
What is loin to groin pain, nausea & vomiting with pyrexia associated with?
Renal calculi
What is pyelonephritis?
Inflammation of kidney
What is pyonephrosis?
Inflammation & obstruction of kidney
What initial treatment may be administered in patient with renal stone?
IV Fluid Bloods Urine & blood culture ABIs Analgesia
What are some emergency treatment options for urinary tract obstruction?
Percutaneous nephrostomy insertion
Retrograde stent insertion
What is the main treatment for patient with retention?
Catheterisation (Foley)
What complication can occur in patients presenting with chronic retention after catheterisation?
Post obstructive diuresis (pathological)
What imaging would you want to do in LUT obstruction?
USS
Bladder scan
Xray
CT KUB
What are the different types of chronic retention?
High pressure & low pressure
What are some of the symptoms of high pressure chronic retention?
Painless
Incontinent
Rasied Cr
Bilateral hydronephrosis
What are some of the symptoms in low pressure chronic retention?
Painless
Dry
Normla Cr
Normal kidneys
Which type of chronic retention is most harmful?
High pressure
What is defined as post obstructive duiresis? What can it lead to?
Greater than 200mls/hr after catheterisation
Electrolyte imbalance
What areas in the Upper UT can obstructions occur?
Pelviureteric junction
Ureter
Vescio-ureteric junction
What are some if the intrinsic causes of obstruction at the PUJ?
Physiological obstruction
Stone
Ureteric tumour (TCC)
Blood clot
What are some of the intrinsic causes of ureter obstruction?
Stone
Ureteric tumour (TCC)
Scar tissue
Blood clot
What are some of the intrinsic causes of ureteric obstruction at the VUJ?
Stone
Tumour (TCC) - bladder & ureteric
What are some extrinsic causes of UT obstruction?
Lymph node tumour
Abdominal tumours
What is the name of a 2 port catheter?
Foley catheter
What are some of the signs of acute urinary retention?
Painful
Inability to void
Palpable & percussible bladder
What are the usual residual volumes associated with acute urinary retention?
500ml- 1L
What are some of the signs of chronic urinary retention?
Painless
Palpable
Percussible bladder after voiding
What is the residual volume which usually remains within the bladder with chronic urinary retention?
400ml-2L
