Urology - retention Flashcards
1
Q
Sx acute retention? vol?
A
tender bladder
600ml
2
Q
causes retention?
A
prostatic obstruction urethral strictures anticholinergics "holding" alcohol constipation post-op infection neuro (cauda equina) carcinoma
3
Q
Ex of retention?
A
abdomen
DRE prostate
perianal sensation
4
Q
Ix retention?
A
MSU U+E FBC PSA renal USS
5
Q
Tx retention?
A
tricks (analgesia, privacy, ambulation, standing to void, running taps, hot bath)
- catheterisation
- start tamsulosin (a blocker)
6
Q
prevention Tx for retention?
A
finasteride (↓ prostate size)
tamsulosin (↓ recatheterisation risk)
7
Q
Sx chronic retention?
A
may be painless >1.5L overflow incontinence acute on chronic lower abdo mass UTI renal failure (bilateral obstructive uropathy)
8
Q
causes chronic retention?
A
prostatic enlargement malignancy rectal surgery DM CNS disease (transverse myelitis, MS) zoster S2-S4
9
Q
when to catheterise in chronic retention?
A
pain
infection
renal impairment
10
Q
Ix if suspected obstructed kidney? (in chronic retention)
A
USS!
U+E (beware ↑ K+, Na+ and HCO3- replacement as lost in urine)
ABG (compensated metabolic acidosis)
urine output (chart + IV fluids!)
MC+S (treat infection)
FBC (↑ wbc + ↑ CRP could be part of stress response)
