Urology Flashcards
What is the most common cause of LUTS in
- men
- women
- BPH
2. UTI
name 3 lifestyle factors that may exacerbate LUTS
- late night fluid intake
- excess alcohol intake
- excess caffeine intake
- What are storage symptoms caused by?
2. Name 4 examples of storage symptoms
- when the bladder has problems storing urine
- increased urinary frequency
nocturia
urgency
urge incontinence
- what are voiding symptoms caused by?
2. name 4 examples of voiding symptoms
- occur due to bladder outlet obstruction
- hesitancy
poor flow
terminal dribble
feeling of incomplete emptying
Name 3 symptoms associated to LUTS that are associated to ask about
- haematuria
- suprapubic discomfort
- colicky pain
name 3 classes of medication that can exacerbate LUTS
- anticholinergics
- antihistamines
- bronchodilators
What scoring system can be used to assess LUTS (and impact on QOL)
IPSS
Define the following:
- Stress incontinence
- Urge incontinence
- Mixed incontinence
- Overflow incontinence
- continuous incontinence
- intra-abdominal pressure > urethral pressure. Most commonly caused by pelvic floor weakness
- Overactive bladder/detrusor hyperactivity leads to uninhibited bladder contraction
- combination of stress and urge incontinence
- normally a complication of chronic urinary retention. progressive stretching of the bladder leads to damage to the efferent fibres of the micturition reflex and loss of bladder sensation. Gross distension causes intravesicular pressure to build, leading to a constant dribbling of urine
- constant leakage of urine, typically due to anatomical abnormality or bladder fistulae.
Which type of urinary retention is:
- painful
- painless
- acute
2. chronic
Name 5 causes of acute urinary retention
- BPH
- UTIs (can cause urethral sphincter to close)
- constipation (compression of urethra)
- antimuscarinics and spinal/epidural anaesthesia
- neuropathy
Name investigations for acute urinary retention
- bedside bladder scan
- routine bloods
- urine culture
- ultrasound of urinary tract
how does chronic urinary retention occur?
chronic urinary retention can cause progressive distension of the bladder
This can lead to detrusor muscle hypertrophy and bladder desensitisation
What is a complication of catheterisation following urinary retention?
post-obstructive diuresis
How may a patient with acute on chronic retention present?
minimal discomfort despite large residual volumes due to bladder desensitisation
Define the following:
- uncomplicated UTI
- Complicated UTI
- Recurrent UTI
- UTI relapse
- infection in a healthy, non-pregnant, pre-menopausal female patient with an anatomically and functionally normal urinary tract
- infection associated with factors increasing colonisation and decreasing effect of therapy:
- hx of childhood utis
- immunocompromised
- preadolescent or post-menopausal
- pregnant
- underlying metabolic disorder
- urological abnormalities - bacteriuria is absent after treatment for at least 14 days followed by recurrence of infection with the same or different organisms Defined as 2 or more infections in 6 months, or>3 infections in 12 months
- recurrence of bacteruria with the same organism within 7 days of completion of antibacterial treatment. Treatment failure may suggest associated stones, scarred kidneys, polycystic disease or bacterial prostatitis
Name 2 common causative organisms of UTIs
- Urogenic E.coli
2. Staph saprophyticus
Name 8 risk factors for UTI
- female
- new sexual activity (particularly in females)
- indwelling urinary catheter
- urinary tract stones
- urinary tract stasis
- diabetes
- immunosuppression
- dementia
Name 5 clinical features of cystitis
- frequency of micturition
- painful voiding
- suprapubic pain and tenderness
- haematuria
- foul smelling urine
name 4 clinical features of pyelonephritis
- loin pain and tenderness
- fever
- rigors
- night sweats
How may an elderly person with a UTI present
may be asymptomatic with new confusion the only symptom
- How can uncomplicated UTIs be diagnosed in women under 65?
- How can UTIs be diagnosed in other patient groups?
- presence of dysuria, urgency, and frequency. Urine dip can be done but does not enhance diagnostic sensitivity
- culture of clean-catch mid stream urine specimen